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General NPI Number Information
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NPI Number | 1235424219
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Entity Type | Individual
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Provider Name | CASEY MARIE SMITH L.AC., DIPL. AC.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 12114 VENICE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-3812
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Country | US
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Telephone | 310-399-5388
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Fax |
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Provider Business Mailing Address
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Address Line | 10866 WASHINGTON BLVD. #22
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City | CULVER CITY
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State | CA
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Zip | 90232
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Country | US
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Telephone | 310-399-5388
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC-8303
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | NCC22627
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 8303
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License Number State | CA
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