Provider Demographics
NPI:1801899398
Name:SMITH, RONALD W (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3521 LOMITA BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5041
Mailing Address - Country:US
Mailing Address - Phone:310-534-9131
Mailing Address - Fax:310-534-9132
Practice Address - Street 1:2840 LONG BEACH BLVD
Practice Address - Street 2:#440
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1590
Practice Address - Country:US
Practice Address - Phone:562-424-9444
Practice Address - Fax:562-988-0309
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2012-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA82278207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A228781Medicaid
CAWA22878DMedicare PIN
CAAV793ZMedicare PIN