Smith, Douglas A
Smith, Douglas A is an sole proprietor health care provider with primary practice located at 12340 Seal Beach Blvd # B641 , Seal Beach CA 90740-2792. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Smith, Douglas A can be contacted via phone (562) 596-6837.Contact Information
Primary practice address
12340 Seal Beach Blvd # B641
Seal Beach CA 90740-2792
Phone: (562) 596-6837
Fax: (562) 596-6837
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | G42932 | California |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | G42932 | California |
| Allopathic & Osteopathic Physicians / Pediatric Dermatology | 207NP0225X | G42932 | California |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | G42932 | California |
Profile Details
| NPI number | 1497809396 |
|---|---|
| LBN Legal business name | Smith, Douglas A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Mar 23rd, 2017 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497809396 | NPPES |
| Other | 05D0554803 | CMS CLIA | |
| MEDICAID | 00G429321 | CMS CLIA | |
| MEDICAID | 00G429320 | CMS CLIA |
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