Provider Demographics
NPI:1336699065
Name:SMOTHERS, APINYA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:APINYA
Middle Name:
Last Name:SMOTHERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-4204
Mailing Address - Country:US
Mailing Address - Phone:209-827-4747
Mailing Address - Fax:209-827-5831
Practice Address - Street 1:1045 5TH ST
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-4204
Practice Address - Country:US
Practice Address - Phone:209-827-4747
Practice Address - Fax:209-827-5831
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54037363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant