Individual
MR. LAURENCE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8648 PINYON ST, BUENA PARK, CA 90620-4055
(714) 280-2281
Mailing address
8648 PINYON ST, BUENA PARK, CA 90620-4055
(714) 280-2281
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
610487
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN
610487
CA
Enumeration date
03/10/2016
Last updated
03/10/2016
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