Provider Demographics
NPI:1679643472
Name:SMOLOWE, JOHN S
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:SMOLOWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N CALIFORNIA AVE STE 202B
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-4105
Mailing Address - Country:US
Mailing Address - Phone:650-328-4788
Mailing Address - Fax:650-327-7652
Practice Address - Street 1:305 N CALIFORNIA AVE STE 202B
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-4105
Practice Address - Country:US
Practice Address - Phone:650-328-4788
Practice Address - Fax:650-327-7652
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG268862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry