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General NPI Number Information
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NPI Number | 1396033395
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Entity Type | Individual
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Provider Name | ERIK KRISTOPHER SMITH PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 925 BEVINS CT
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City | LAKEPORT
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State | CA
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Zip | 95453-9754
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Country | US
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Telephone | 707-263-8382
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Fax |
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Provider Business Mailing Address
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Address Line | 729 SUNRISE AVE STE 602
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City | ROSEVILLE
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State | CA
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Zip | 95661-4542
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Country | US
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Telephone | 916-953-7571
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Fax | 916-771-8515
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA21692
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License Number State | CA
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