| Dwight H. Smith, M.d., Inc | |
|
1711 W Temple St 7th Floor Los Angeles CA 90026-5421 | |
| (213) 413-0001 | |
| Not Available |
| Full Name | Dwight H. Smith, M.d., Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1711 W Temple St, Los Angeles, California |
| Authorized Official Name and Position | Dwight Smith (PRESIDENT) |
| Authorized Official Contact | 3236781111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dwight H. Smith, M.d., Inc 165 N La Brea Ave Inglewood CA 90301-1707 Ph: (332) 678-1111 | Dwight H. Smith, M.d., Inc 1711 W Temple St 7th Floor Los Angeles CA 90026-5421 Ph: (213) 413-0001 |
| NPI Number | 1942338876 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6709867005 |
|---|---|
| Medicare Enrollment ID | O20040524001500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942338876 | NPI | - | NPPES |
| 00C378540 | Medicaid | CA | |
| 00C378541 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Dwight Smith |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346384864 PECOS PAC ID: 0648251934 Enrollment ID: I20040524001491 |
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