Healthcare Provider Details

I. General information

NPI: 1821452921
Provider Name (Legal Business Name): MARGARET VAN VEEN SMITH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CAMINO ALTO
MILL VALLEY CA
94941-2974
US

IV. Provider business mailing address

1 CAMINO ALTO
MILL VALLEY CA
94941-2974
US

V. Phone/Fax

Practice location:
  • Phone: 415-388-2701
  • Fax: 415-388-7142
Mailing address:
  • Phone: 415-388-2701
  • Fax: 415-388-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55634
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: