MEDICARE: ABIGAIL SMITH

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	3747P1801X	Personal Care Attendant		NV
2	251E00000X	Home Health Agency		AZ
3	251E00000X	Home Health Agency		GA
4	374U00000X	Home Health Aide	2084N0400X	CA

General Provider Information

NPI Number	:	1972993756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL SMITH

Provider Business Mailing Address
First Line	:	19744 BEACH BLVD # 540
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-2988
Country	:	US
Telephone Number	:	949-710-0949
Fax Number	:	775-541-0833

Provider Business Practice Location Address
First Line	:	137 E ELLIOT RD UNIT 2896
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85299-6838
Country	:	US
Telephone Number	:	310-908-1861
Fax Number	:	775-541-0833

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

Provider Enumeration Date	:	01/30/2015
Last Update Date	:	01/12/2026

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Directions to “ ABIGAIL SMITH ” Practice Location

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