Provider Demographics
NPI:1659339745
Name:DESAI, SMITA A (DO)
Entity Type:Individual
Prefix:DR
First Name:SMITA
Middle Name:A
Last Name:DESAI
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Gender:F
Credentials:DO
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Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:#8373
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9000
Mailing Address - Country:US
Mailing Address - Phone:619-543-7300
Mailing Address - Fax:619-543-7344
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:#8373
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:619-543-7300
Practice Address - Fax:619-543-7344
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2021-11-18
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Provider Licenses
StateLicense IDTaxonomies
CA20A9425207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine