Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 30665 | CA |
Y | 213EG0000X | General Practice | 30665 | CA |
NPI | 1003905142 |
---|---|
Provider Name | Mrs. Maria Smolenski |
First Address | Los Altos, CA 94024-5495 |
Second Address | Los Altos, AL 94024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |