Stacy R Smith, MD Apc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G65407 Issued in CA

Legal business name

STACY R SMITH, MD APC

Practice address

2371 Lagoon View Dr
Cardiff, CA 92007-1507

Phone

(619) 787-5723

Fax

(619) 342-7428

NPI assigned

Nov 19, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stacy Smith, MD

Title

President

Phone

(760) 203-3839

Specialties & licenses 1

Addresses

Other names 1

• California Dermatology & Clinical Research Institute Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1114357605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 SAXONY PL",
            "address_2": "SUITE 102",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920247700",
            "telephone_number": "760-203-3839",
            "fax_number": "760-203-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2371 LAGOON VIEW DR",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920071507",
            "telephone_number": "619-787-5723",
            "fax_number": "619-342-7428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY R SMITH, MD APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-203-3839",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G65407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Dermatology & Clinical Research Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jill Ellen Siegelman, MFT
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• Spektacles Optometry and Eyewear Inc.
• Spiral Physical Therapy Inc.
• Dianne Sterling, PSY.D.
• Sunder Enterprises Inc.
• Sunnier Days Psychology, Inc.
• Brandy Jo Ann Tamez
• Nicholas Torn

• Dermatology Physician in Cardiff, CA
• Providers in Cardiff, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.