Active NPI
Daniel Aaron Smith, MD
- Family Medicine Physician
- San Rafael, CA
National Provider Identifier
1154335966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A77141
- Practice address
- 99 Montecillo Rd
San Rafael, CA 94903-3308 - Phone
- (415) 444-4873
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A77141 | CA | Primary |
| Family Medicine Physician | 207Q00000X | 5431 | AK |
Addresses
Primary practice location
99 Montecillo Rd
San Rafael, CA 94903-3308
Mailing address
99 Montecillo Rd
San Rafael, CA 94903-3308
Phone (415) 444-4873
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5431 | Other | AK | MEDICAL LICENSE |
| A77141 | Other | CA | MED BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77141 | CA | MD | Pharmacist |
| A77141 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1154335966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 MONTECILLO RD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949033308",
"telephone_number": "415-444-4873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 MONTECILLO RD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949033308",
"telephone_number": "415-444-4873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DANIEL",
"middle_name": "AARON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A77141",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "5431",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "5431",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED BOARD",
"identifier": "A77141",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.