Smith, Evelyn Renee

Smith, Evelyn Renee is an sole proprietor health care provider with primary practice located at 842 California Blvd , San Luis Obispo CA 93401-2902. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Smith, Evelyn Renee can be contacted via phone (805) 542-9678.

Contact Information

Primary practice address
842 California Blvd San Luis Obispo CA 93401-2902
Phone: (805) 542-9678
Fax: (805) 542-9685
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G77320 California

Profile Details

NPI number 1194762070
LBN Legal business name Smith, Evelyn Renee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2006
Last updated Feb 8th, 2022 - about 3 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 1194762070 NPPES
Utah Other 616024300 ACS/US DEPT LABOR
Utah Other 56-2593593 ACS/US DEPT LABOR
Utah Other FL915Z ACS/US DEPT LABOR
Utah Other 000067751 ACS/US DEPT LABOR

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