Provider Demographics
NPI:1669853644
Name:MILES SMITH, CHAMIKA MONIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:CHAMIKA
Middle Name:MONIQUE
Last Name:MILES SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHAMIKA
Other - Middle Name:MONIQUE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:KAISER PERMANENTE FOUNDATION HOSPITAL MORENO VALLEY
Mailing Address - Street 2:27300 IRIS AVENUE
Mailing Address - City:MORENO VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:92555
Mailing Address - Country:US
Mailing Address - Phone:951-243-0811
Mailing Address - Fax:
Practice Address - Street 1:27300 IRIS AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4802
Practice Address - Country:US
Practice Address - Phone:951-243-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY562319879207V00000X
CAA159249207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology