Smith, Kevin A
Smith, Kevin A is an sole proprietor health care provider with primary practice located at 525 Melissa Ave Ste A , Barstow CA 92311-3002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Kevin A can be contacted via phone (760) 255-2400.Contact Information
Primary practice address
525 Melissa Ave Ste A
Barstow CA 92311-3002
Phone: (760) 255-2400
Fax: (760) 588-4990
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | CAG77804 | California |
Profile Details
| NPI number | 1386630895 |
|---|---|
| LBN Legal business name | Smith, Kevin A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 21st, 2005 |
| Last updated | Aug 24th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386630895 | NPPES |
| California | MEDICAID | 00G778041 |
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