Provider Demographics
NPI:1619621646
Name:SMITH, ISABEL LANFAIR (DC)
Entity Type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:LANFAIR
Last Name:SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-0030
Mailing Address - Country:US
Mailing Address - Phone:774-836-1007
Mailing Address - Fax:
Practice Address - Street 1:16776 BERNARDO CENTER DR STE 211
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2559
Practice Address - Country:US
Practice Address - Phone:858-675-1140
Practice Address - Fax:858-675-1144
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor