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General NPI Number Information
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NPI Number | 1265645444
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Entity Type | Individual
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Provider Name | CHARLES A SMITH RPH
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3941 SPRING RD
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City | MOORPARK
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State | CA
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Zip | 93021-2300
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Country | US
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Telephone | 805-529-5726
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Fax | 805-529-8533
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Provider Business Mailing Address
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Address Line | 15552 BORGES DR
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City | MOORPARK
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State | CA
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Zip | 93021-3256
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Country | US
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Telephone | 805-990-0464
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Fax | 805-531-9872
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH032780
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License Number State | CA
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