MEDICARE: ALLEN F SMOOT MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A19498	CA

General Provider Information

NPI Number	:	1306028329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN F SMOOT MD INC

Provider Business Mailing Address
First Line	:	2645 OCEAN AVE
Second Line	:	SUITE 301
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1647
Country	:	US
Telephone Number	:	415-585-5492
Fax Number	:	415-585-5422

Provider Business Practice Location Address
First Line	:	2645 OCEAN AVE
Second Line	:	SUITE 301
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1647
Country	:	US
Telephone Number	:	415-585-5492
Fax Number	:	415-585-5422

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALLEN F SMOOT
Credential	:
Telephone Number	:	415-585-5492

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/30/2007

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