Doctor Name: | DR. E. RENEE SMITH |
NPI Number: | 1194762070 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | G77320 |
Business Practice Address: | 1500 Palm St Suite A San Luis Obispo, CA - 934012998 |
Business Phone Number: | 8055429678 |
Business Fax Number: | 8055429685 |
Mailing Address: | 1500 Palm St, Suite A SAN LUIS OBISPO |
State: | CA |
Postal Code: | 934012998 |
Phone Number: | 8055429678 |
Fax Number: | 8055429685 |
NPI Enumeration Date: | 06/01/2006 |
NPI Last Update Date: | 06/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G77320 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |