Healthcare Provider Details

I. General information

NPI: 1013032721
Provider Name (Legal Business Name): SMITH CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 N EL MOLINO AVE #180
PASADENA CA
91101-1873
US

IV. Provider business mailing address

131 N EL MOLINO AVE #180
PASADENA CA
91101-1873
US

V. Phone/Fax

Practice location:
  • Phone: 626-792-1221
  • Fax: 626-792-0082
Mailing address:
  • Phone: 626-792-1221
  • Fax: 626-792-0082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC12544
License Number StateCA

VIII. Authorized Official

Name: DR. STEVEN LEE SMITH
Title or Position: OWNER
Credential: D.C.
Phone: 626-792-1221