MEDICARE: HEIDI LOUISE SMITH D.C.

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	111N00000X	Chiropractor	31823	CA

General Provider Information

NPI Number	:	1699077255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI LOUISE SMITH D.C.

Provider Business Mailing Address
First Line	:	520 N PROSPECT AVE STE 304
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3043
Country	:	US
Telephone Number	:	310-376-5433
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 N PROSPECT AVE STE 304
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3043
Country	:	US
Telephone Number	:	310-376-5433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2010
Last Update Date	:	02/06/2026

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