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General NPI Number Information
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NPI Number | 1124954532
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Entity Type | Organization
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Legal Business Name | STEPHEN J. SMITH PHYSICIAN ASSISTANT, P.C.
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 6651 MADISON AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-0602
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Country | US
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Telephone | 916-903-7520
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Fax |
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Provider Business Mailing Address
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Address Line | 3335 WATT AVE STE B #199
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City | SACRAMENTO
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State | CA
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Zip | 95821-3615
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Country | US
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Telephone | 423-762-2844
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN SMITH
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Credential | PA-C
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Telephone | 423-762-2844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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