Healthcare Provider Details

I. General information

NPI: 1053342675
Provider Name (Legal Business Name): HELEN I SMITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 AVALON BLVD
LOS ANGELES CA
90011-5622
US

IV. Provider business mailing address

4211 AVALON BLVD
LOS ANGELES CA
90011-5622
US

V. Phone/Fax

Practice location:
  • Phone: 323-852-2251
  • Fax: 323-852-2251
Mailing address:
  • Phone: 323-852-2251
  • Fax: 323-852-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG88738
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: