Healthcare Provider Details

I. General information

NPI: 1386759108
Provider Name (Legal Business Name): ALBERTINA D SMITH-BANKS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 E FLORIDA AVE
HEMET CA
92543-4510
US

IV. Provider business mailing address

1023 E FLORIDA AVE
HEMET CA
92543-4510
US

V. Phone/Fax

Practice location:
  • Phone: 951-599-8403
  • Fax: 951-766-0930
Mailing address:
  • Phone: 951-599-8403
  • Fax: 951-766-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC199368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: