| Richard Colville Smith, M.d., Inc. | |
|
122 Escondido Ave Suite 101 Vista CA 92084-6055 | |
| (760) 806-9263 | |
| (760) 806-9264 |
| Full Name | Richard Colville Smith, M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 122 Escondido Ave, Vista, California |
| Authorized Official Name and Position | Richard Colville Smith (OWNER) |
| Authorized Official Contact | 7608069263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Colville Smith, M.d., Inc. 122 Escondido Ave Suite 101 Vista CA 92084-6055 Ph: (760) 806-9263 | Richard Colville Smith, M.d., Inc. 122 Escondido Ave Suite 101 Vista CA 92084-6055 Ph: (760) 806-9263 |
| NPI Number | 1043416076 |
|---|---|
| Provider Enumeration Date | 06/26/2007 |
| Last Update Date | 03/06/2015 |
| Medicare PECOS PAC ID | 5597788794 |
|---|---|
| Medicare Enrollment ID | O20060112000936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043416076 | NPI | - | NPPES |
| 00A827520 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Richard C Smith |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518979228 PECOS PAC ID: 8022052026 Enrollment ID: I20050610000342 |
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