Healthcare Provider Details

I. General information

NPI: 1275464927
Provider Name (Legal Business Name): LINNEA V SMITH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LINNEA V RAYNES

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17100 NORWALK BLVD STE 101
CERRITOS CA
90703-2750
US

IV. Provider business mailing address

6061 WELDE CIR
HUNTINGTON BEACH CA
92647-2857
US

V. Phone/Fax

Practice location:
  • Phone: 562-860-2111
  • Fax:
Mailing address:
  • Phone: 657-390-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberPA68332
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: