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General NPI Number Information
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NPI Number | 1376599191
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Entity Type | Individual
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Provider Name | ERIC DAVID SMITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 3301 EL CAMINO REAL STE 100
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City | ATHERTON
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State | CA
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Zip | 94027-3803
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Country | US
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Telephone | 650-364-3080
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Fax | 650-364-2004
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Provider Business Mailing Address
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Address Line | PO BOX 6102
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City | NOVATO
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State | CA
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Zip | 94948-6102
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Country | US
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Telephone | 415-884-3418
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Fax | 415-883-8082
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A68606
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License Number State | CA
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