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General NPI Number Information
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NPI Number | 1023320504
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Entity Type | Individual
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Provider Name | BOBBY DARRELL SMITH II O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 200 S WELLS RD STE 225
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City | VENTURA
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State | CA
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Zip | 93004-1382
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Country | US
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Telephone | 805-659-0250
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Fax | 805-659-9275
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Provider Business Mailing Address
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Address Line | 145 VIA MURCIA
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-3859
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Country | US
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Telephone | 492-902-2869
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13941
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0002729
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License Number State | GA
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