Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 141803 | CA |
NPI | 1013278118 |
---|---|
Provider Name | Stephen J Smith |
First Address | Palo Alto, CA 94303-3216 |
Second Address | Palo Alto, CA 94303-3216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 11/04/2016 |