| Loren Donnell Smith OD Inc | |
|
35149 Newark Blvd Ste C Newark CA 94560-1209 | |
| (510) 796-3937 | |
| Not Available |
| Full Name | Loren Donnell Smith OD Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 35149 Newark Blvd, Newark, California |
| Authorized Official Name and Position | Loren Donnell Smith (CMO/) |
| Authorized Official Contact | 5107963937 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loren Donnell Smith OD Inc 35149 Newark Blvd Ste C Newark CA 94560-1209 Ph: (510) 796-3937 | Loren Donnell Smith OD Inc 35149 Newark Blvd Ste C Newark CA 94560-1209 Ph: (510) 796-3937 |
| NPI Number | 1649692575 |
|---|---|
| Provider Enumeration Date | 01/13/2014 |
| Last Update Date | 01/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649692575 | NPI | - | NPPES |
| SD0073540 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 07354TLG (California) | Primary |
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