Individual
DAVID RICHARD WYNDHAMSMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1509 WILSON TER, GLENDALE, CA 91206-4007
(818) 409-8000
(818) 546-5632
Mailing address
PO BOX 60790, PASADENA, CA 91116-6790
(626) 204-6747
(626) 396-0851
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G72018
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G720180
—
CA
01
—
00G720181
BLUE SHIELD
CA
Enumeration date
07/26/2006
Last updated
06/02/2016
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