Provider Demographics
NPI:1326169962
Name:SMITH, OLIVER FRANK (OD)
Entity Type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:FRANK
Last Name:SMITH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:201 W VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-2608
Mailing Address - Country:US
Mailing Address - Phone:760-489-5100
Mailing Address - Fax:760-489-6567
Practice Address - Street 1:201 W VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2608
Practice Address - Country:US
Practice Address - Phone:760-489-5100
Practice Address - Fax:760-489-6567
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6116T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist