Joseph Phillip Smith, D.C.
Individual provider Active NPI Chiropractor · Fairfax, CA
NPI 1760661920 · NPPES record last updated Aug 23, 2018
Key facts
- NPI
- 1760661920
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 761 (ND)
- Practice address
- 85 Bolinas Rd Ste 2
Fairfax, CA 94930 - Phone
- (415) 459-4411
- Fax
- (415) 226-0450
- NPI assigned
- Oct 24, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29581 | CA | MD | Psychologist |
| 761 | ND | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 29581 | CA | |
| Chiropractor | 111N00000X | 761 | ND | Yes |
Addresses
Primary practice location
85 Bolinas Rd Ste 2
Fairfax, CA 94930
Mailing address
85 Bolinas Rd Ste 2
Fairfax, CA 94930-1626
Phone (415) 459-4411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SMI 25763 | Other | ND | BLUE CROSS BLUE SHIELD |
Other providers in Fairfax, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.