Smith, Clyde W

Smith, Clyde W is an sole proprietor health care provider with primary practice located at 2801 Atlantic Ave , Long Beach CA 90806-1701. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Smith, Clyde W can be contacted via phone (562) 933-1550.

Contact Information

Primary practice address
2801 Atlantic Ave Long Beach CA 90806-1701
Phone: (562) 933-1550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G19005 California
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X G19005 California

Profile Details

NPI number 1891777280
LBN Legal business name Smith, Clyde W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 19th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891777280 NPPES
California MEDICAID 00G190050

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