Vadim Smirnov, CRNA, MSN, MD

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3879 Issued in CA

Practice address

Raymond Renaissance Surgery Center
125 N Raymond Av 212
Pasadena, CA 91103

Phone

(415) 290-0489

NPI assigned

Jan 20, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1144551730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 S MANHATTAN PL APT 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053122",
            "telephone_number": "415-290-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RAYMOND RENAISSANCE SURGERY CENTER",
            "address_2": "125 N RAYMOND AV 212",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91103",
            "telephone_number": "415-290-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIRNOV",
        "first_name": "VADIM",
        "credential": "CRNA, MSN, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2023-02-03",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "3879",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brinell Anderson Slocumb, PSY.D.
• Henry D. Slosser, MD
• Brianne Slusarenko, PT
• Gamal Smalley
• Smart Care Link Inc
• Smith Chiropractic
• Smith Chiropractic Clinic, Inc.
• Adrienne Smith, ACNP
• Brenda Bonilla Smith, L.AC.
• Christopher Paul Smith, M.D.

• Certified Registered Nurse Anesthetist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.