Healthcare Provider Details

I. General information

NPI: 1013342567
Provider Name (Legal Business Name): AARON MATHEW SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 FROST ST
SAN DIEGO CA
92123-2771
US

IV. Provider business mailing address

8745 AERO DR STE 200
SAN DIEGO CA
92123-1774
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-3600
  • Fax:
Mailing address:
  • Phone: 858-565-0950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA131758
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA131758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: