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
Fax: (858) 609-7106
Website:

Health care specialties

SpecialtyCodeLicense #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 2 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 1255490330 NPPES
California MEDICAID 00G556410

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