Healthcare Provider Details

I. General information

NPI: 1285616557
Provider Name (Legal Business Name): LLOYD H. SMITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST OB/GYN, SUITE 2500
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST OB/GYN, SUITE 2500
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6946
  • Fax: 916-734-6031
Mailing address:
  • Phone: 916-734-6946
  • Fax: 916-734-6031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberG47928
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: