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

Last updated

Jul 19, 2008By the provider in NPPES

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.NPI 1124143334

Title

President

Phone

(909) 628-6556

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carl W. Smith, M.D.

  • Specialist
  • Chino, CA
  • NPI 1124143334
  Authorized official Same address or phone

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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• Abigail Marie Carino-Romo, N.P.
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• Roy Carranza Jr., CCAPP CI28760120
• Peter Paul Carreon, FNP
• Martin Antonio Carrillo, M.D.

• 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.