| NPI | 1679759286 |
|---|---|
| Doing Business As | CHANNEL ISLANDS MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DEAN WALTER SMITH Medical Director 805-477-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A71919) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2021-01-28 |