Provider Demographics
NPI:1568682979
Name:SMITH, STEVEN LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LAWRENCE
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7212 ORANGETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3341
Mailing Address - Country:US
Mailing Address - Phone:714-503-6550
Mailing Address - Fax:714-409-3075
Practice Address - Street 1:7212 ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3341
Practice Address - Country:US
Practice Address - Phone:714-503-6550
Practice Address - Fax:714-409-3075
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2020-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG82144207Q00000X
CA82144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF39318Medicare UPIN