Smith, Damien L

Smith, Damien L is an individual health care provider with primary practice located at 2911 Chanticleer Ave , Santa Cruz CA 95065. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Smith, Damien L can be contacted via phone (831) 477-2350.

Contact Information

Primary practice address
2911 Chanticleer Ave Santa Cruz CA 95065
Phone: (831) 477-2350
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X A112593 California

Profile Details

NPI number 1063603108
LBN Legal business name Smith, Damien L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Jun 20th, 2018 - about 6 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 1063603108 NPPES
Louisiana MEDICAID 1091430
Louisiana Other DV559V

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