Individual
BRYAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
302 W 5TH ST STE 308, SAN PEDRO, CA 90731-2750
(424) 570-6955
(424) 363-1721
Mailing address
302 W 5TH ST STE 308, SAN PEDRO, CA 90731-2750
(424) 570-6955
(424) 363-1721
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
CA
Other
Enumeration date
08/12/2024
Last updated
08/25/2024
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