Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G528340 | CA |
Y | 208600000X | Surgeon | G528340 | CA |
N | 2086X0206X | Surgical Oncologist | G528340 | CA |
NPI | 1225046451 |
---|---|
Provider Name | Lynn M Smolik |
First Address | Caroga Lake, NY 12032-0063 |
Second Address | San Carlos, CA 94070-3919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F18264 | (02) |