Provider Demographics
NPI:1770808859
Name:SMITH, ERICA ANNE (MD)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ANNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:ANNE
Other - Last Name:SCHIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3626 RUFFIN RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1810
Mailing Address - Country:US
Mailing Address - Phone:858-565-9666
Mailing Address - Fax:858-565-9441
Practice Address - Street 1:3626 RUFFIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1810
Practice Address - Country:US
Practice Address - Phone:858-565-9666
Practice Address - Fax:858-565-9441
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118772207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program