Healthcare Provider Details

I. General information

NPI: 1306872841
Provider Name (Legal Business Name): DANIEL JAMES SMEESTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 10/13/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 DEERWOOD RD STE 235
SAN RAMON CA
94583-4409
US

IV. Provider business mailing address

111 DEERWOOD RD STE 235
SAN RAMON CA
94583-4409
US

V. Phone/Fax

Practice location:
  • Phone: 925-640-5441
  • Fax:
Mailing address:
  • Phone: 925-289-1430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA86415
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA86415
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: