Provider Demographics
NPI:1396904876
Name:LAMALE-SMITH, LEAH MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:MICHELLE
Last Name:LAMALE-SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MICHELLE
Other - Last Name:LAMALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:MAIL CODE 8433
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9000
Mailing Address - Country:US
Mailing Address - Phone:619-543-2384
Mailing Address - Fax:619-543-3703
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:MAIL CODE 8433
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:619-543-2384
Practice Address - Fax:619-543-3703
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL30948207V00000X
CO50787207V00000X
CAA135831207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33134723Medicaid
CO33134723Medicaid