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General NPI Number Information
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NPI Number | 1265619035
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Entity Type | Organization
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Legal Business Name | SAMUEL J. SMITH,M.D,INC
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 8641 WILSHIRE BLVD STE 220
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2900
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Country | US
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Telephone | 310-659-3258
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Fax |
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Provider Business Mailing Address
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Address Line | 8641 WILSHIRE BLVD STE 220
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2900
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Country | US
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Telephone | 310-659-3258
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMUEL J SMITH
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Credential | M.D.
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Telephone | 310-659-3251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G13861
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License Number State | CA
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