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General NPI Number Information
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NPI Number | 1942484043
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Entity Type | Individual
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Provider Name | VICTORIA MARIE SMITH P.A.
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Gender | Female
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 7900 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90046-3304
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Country | US
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Telephone | 323-785-2064
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Fax |
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Provider Business Mailing Address
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Address Line | 13421 HUBBARD ST UNIT 104
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City | SYLMAR
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State | CA
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Zip | 91342-4474
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Country | US
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Telephone | 818-367-5059
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA12417
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License Number State | CA
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