Provider Demographics
NPI:1124239835
Name:SMITH-LANG, SANDRA KATHLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KATHLEEN
Last Name:SMITH-LANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 31ST ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3404
Mailing Address - Country:US
Mailing Address - Phone:310-890-6209
Mailing Address - Fax:310-546-2955
Practice Address - Street 1:578 31ST ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-3404
Practice Address - Country:US
Practice Address - Phone:310-890-6209
Practice Address - Fax:310-546-2955
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA421792080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine