Healthcare Provider Details

I. General information

NPI: 1770532046
Provider Name (Legal Business Name): STEVEN L SMITH DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 06/20/2008
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:
Title or Position:
Credential:
Phone: