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General NPI Number Information
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NPI Number | 1467644013
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Entity Type | Organization
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Legal Business Name | CRAIG V SMITH M.D. INC.
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 866 N VERMONT AVE 3
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City | LOS ANGELES
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State | CA
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Zip | 90029-3587
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Country | US
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Telephone | 323-667-0660
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Fax | 323-660-7027
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Provider Business Mailing Address
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Address Line | 866 N VERMONT AVE 3
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City | LOS ANGELES
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State | CA
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Zip | 90029-3587
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Country | US
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Telephone | 323-667-0660
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Fax | 323-660-7027
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Authorized Official
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Title or Position | CEO
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Name | DR. CRAIG V SMITH
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Credential | M D
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Telephone | 323-667-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G61164
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License Number State | CA
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