Provider Demographics
NPI:1861401002
Name:SMITH, RYAN STUART (DO)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:STUART
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5050 AVENIDA ENCINAS STE 200
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-4383
Mailing Address - Country:US
Mailing Address - Phone:760-439-1963
Mailing Address - Fax:760-268-0931
Practice Address - Street 1:4002 VISTA WAY
Practice Address - Street 2:EMERGENCY DEPT.
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4506
Practice Address - Country:US
Practice Address - Phone:760-439-1963
Practice Address - Fax:760-268-0931
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A8897207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine