Loren Donnell Smith Od INC
Clinic/Center in Newark, CA. Organization (NPI-2).
NPI number1649692575
StatusActive
Last updated in NPPESJan 13, 2014
Details
- NPI
- 1649692575
- Entity type
- Organization (NPI-2)
- Legal business name
- Loren Donnell Smith Od INC
- Organization subpart
- No
- Enumeration date
- Jan 13, 2014
- Last updated
- Jan 13, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 07354TLG | CA | Yes |
Practice location
35149 Newark BlvdSte C
Newark, CA 94560-1209
Phone 510-796-3937
Mailing address
35149 Newark BlvdSte C
Newark, CA 94560-1209
Phone 510-796-3937
Authorized official
Loren Donnell Smith
Cmo/
5107963937
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