Provider Demographics
NPI:1053579979
Name:SMITH, ASHLEY ANN (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 472590
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94147-2590
Mailing Address - Country:US
Mailing Address - Phone:415-814-3813
Mailing Address - Fax:415-217-3883
Practice Address - Street 1:2330 MARINSHIP WAY
Practice Address - Street 2:SUITE 370
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965-2800
Practice Address - Country:US
Practice Address - Phone:415-887-9758
Practice Address - Fax:707-829-7629
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99407207N00000X, 207ND0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology