Carl W. Smith, M.D., Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G40206 Issued in CA

Legal business name

CARL W. SMITH, M.D., INC.

Practice address

12598 Central Ave
Suite 109
Chino, CA 91710-3502

Phone

(909) 628-6556

Fax

(909) 628-3831

NPI assigned

Jul 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Carl W. Smith, M.D.

Title

President

Phone

(909) 628-6556

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216425600000",
    "number": "1649435637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12598 CENTRAL AVE",
            "address_2": "SUITE 109",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103502",
            "telephone_number": "909-628-6556",
            "fax_number": "909-628-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12598 CENTRAL AVE",
            "address_2": "SUITE 109",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103502",
            "telephone_number": "909-628-6556",
            "fax_number": "909-628-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL W. SMITH, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-19",
        "last_updated": "2008-07-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-628-6556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G40206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Chino, CA
• Providers in Chino, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; 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.