Healthcare Provider Details

I. General information

NPI: 1710007026
Provider Name (Legal Business Name): KARA SMOLINSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6605 NANCY RIDGE DR
SAN DIEGO CA
92121-2253
US

IV. Provider business mailing address

6605 NANCY RIDGE DR
SAN DIEGO CA
92121-2253
US

V. Phone/Fax

Practice location:
  • Phone: 858-900-2766
  • Fax: 858-750-2984
Mailing address:
  • Phone: 858-900-2766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35.097237
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberLT4235
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number35.097237
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number177895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: