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General NPI Number Information
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NPI Number | 1215022736
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Entity Type | Individual
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Provider Name | GEORGE H SMALL M.D
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 1800 WESTERN AVE STE 101
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1352
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Country | US
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Telephone | 909-885-1542
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Fax | 909-327-2756
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Provider Business Mailing Address
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Address Line | PO BOX 10999-0999
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City | SAN BERNARDINO
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State | CA
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Zip | 92423
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Country | US
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Telephone | 909-528-3639
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Fax | 909-783-8985
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A34324
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A34324
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License Number State | CA
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