Healthcare Provider Details

I. General information

NPI: 1396754578
Provider Name (Legal Business Name): BARBARA ANN SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL CIR
WESTMINSTER CA
92683-3910
US

IV. Provider business mailing address

14120 ALONDRA BLVD STE C
SANTA FE SPRINGS CA
90670-5842
US

V. Phone/Fax

Practice location:
  • Phone: 562-407-2080
  • Fax: 562-407-2082
Mailing address:
  • Phone: 562-407-2080
  • Fax: 562-407-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG53925
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: