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Individual
MR. ROBERT J SMITH
Active
Individual
MR. ROBERT J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20267
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PA202670
CIGNA DME
CA
01
—
PA20267
LICENSE NUMBER
CA
05
—
PA20267
—
CA
Enumeration date
05/04/2007
Last updated
12/03/2008
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