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General NPI Number Information
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NPI Number | 1912997008
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Entity Type | Individual
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Provider Name | ROGER A SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1121 E WASHINGTON AVE
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City | ESCONDIDO
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State | CA
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Zip | 92025-2214
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Country | US
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Telephone | 760-871-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 1695 N SUNRISE WAY
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City | PALM SPRINGS
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State | CA
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Zip | 92262-3701
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Country | US
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Telephone | 760-323-2118
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | H1915
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C162774
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License Number State | CA
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