THOMAS E SMITH DPM NPI 1417982950

NPI Information

NPI: 1417982950
Provider Name: THOMAS E SMITH, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
425 W BONITA AVE STE 110
SAN DIMAS, CA
ZIP 91773
Phone: (909) 599-0981
Get Directions

Thomas E Smith, DPM is a podiatrist in San Dimas, CA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Thomas E Smith, DPM NPI is 1417982950. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

425 W BONITA AVE STE 110
SAN DIMAS, CA
ZIP 91773-543
Phone: (909) 599-0981
Fax: (909) 592-0738

The NPI 1417982950 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 7/12/2006 and was last updated on 5/13/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		E2504	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000E25040	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
2	480002990	OTHER	CALIFORNIA	PALMETTO GBA
3	E2504	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
4	T77488	MEDICARE UPIN	CALIFORNIA
5	000E25041	MEDICAID	CALIFORNIA
6	480012426	OTHER	CALIFORNIA	PALMETTO GBA
7	000E25040	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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