| Clark E. Smith, M.d. A Medical Corporation | |
|
9820 Willow Creek Rd Suite 370 San Diego CA 92131 | |
| (858) 530-9112 | |
| (858) 530-9118 |
| Full Name | Clark E. Smith, M.d. A Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 9820 Willow Creek Rd, San Diego, California |
| Authorized Official Name and Position | Clark E. Smith (OWNER) |
| Authorized Official Contact | 8585309112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark E. Smith, M.d. A Medical Corporation 9820 Willow Creek Rd Suite 370 San Diego CA 92131 Ph: (858) 530-9112 | Clark E. Smith, M.d. A Medical Corporation 9820 Willow Creek Rd Suite 370 San Diego CA 92131 Ph: (858) 530-9112 |
| NPI Number | 1942444120 |
|---|---|
| Provider Enumeration Date | 05/01/2009 |
| Last Update Date | 05/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942444120 | NPI | - | NPPES |
| 00G491050 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G49105 (California) | Primary |
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