Healthcare Provider Details

I. General information

NPI: 1811939176
Provider Name (Legal Business Name): LORA D YEAGER-SMITH DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 W EL NORTE PKWY APT 35
ESCONDIDO CA
92026-3356
US

IV. Provider business mailing address

1051 W EL NORTE PKWY APT 35
ESCONDIDO CA
92026-3356
US

V. Phone/Fax

Practice location:
  • Phone: 951-396-1538
  • Fax:
Mailing address:
  • Phone: 951-396-1538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number161
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE5822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: