Provider Demographics
NPI:1922849025
Name:SMITH, JAHI GARRETT (DC)
Entity type:Individual
Prefix:
First Name:JAHI
Middle Name:GARRETT
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CENTURY PARK E STE 1503
Mailing Address - Street 2:
Mailing Address - City:CENTURY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2018
Mailing Address - Country:US
Mailing Address - Phone:310-478-7775
Mailing Address - Fax:
Practice Address - Street 1:2080 CENTURY PARK E STE 1503
Practice Address - Street 2:
Practice Address - City:CENTURY CITY
Practice Address - State:CA
Practice Address - Zip Code:90067-2018
Practice Address - Country:US
Practice Address - Phone:310-478-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor