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NPI Code Detail

MEDICARE: DR. HEIDI SULMAN-SMITH M.D.

MEDICARE:  DR. HEIDI  SULMAN-SMITH  M.D.
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
12084P0804XChild & Adolescent Psychiatry PhysicianA63327CA
22084P0800XPsychiatry PhysicianA63327CA

General Provider Information

NPI Number : 1922082700
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEIDI SULMAN-SMITH M.D.
Provider Business Mailing Address
First Line : 815 N EL CENTRO AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90038-3805
Country : US
Telephone Number : 323-769-7167
Fax Number :
Provider Business Practice Location Address
First Line : 815 N EL CENTRO AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90038-3805
Country : US
Telephone Number : 323-769-7167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 06/17/2013

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Directions to “ DR. HEIDI SULMAN-SMITH M.D.” Practice Location

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