Smith, Mark David
Smith, Mark David is an individual health care provider with primary practice located at 7695 Cardinal Ct Ste 100 , San Diego CA 92123-3357. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Smith, Mark David can be contacted via phone (858) 609-7100.Contact Information
Primary practice address
7695 Cardinal Ct Ste 100
San Diego CA 92123-3357
Phone: (858) 609-7100
Fax: (858) 609-7106
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | G55641 | California |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | G55641 | California |
Profile Details
| NPI number | 1255490330 |
|---|---|
| LBN Legal business name | Smith, Mark David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 6th, 2006 |
| Last updated | Nov 10th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255490330 | NPPES |
| California | MEDICAID | 00G556410 |
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