Healthcare Provider Details

I. General information

NPI: 1790847945
Provider Name (Legal Business Name): JAMES ANTHONY SMITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 BARCLAY AVE
MILLBRAE CA
94030-2459
US

IV. Provider business mailing address

219 BARCLAY AVE
MILLBRAE CA
94030-2459
US

V. Phone/Fax

Practice location:
  • Phone: 650-697-0605
  • Fax: 650-692-2609
Mailing address:
  • Phone: 650-697-0605
  • Fax: 650-692-2609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA232970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: