Organization
J. NEVIN SMITH, M.D., INC
Active
Other names
VALLEY OF THE MOON UROLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH NEVIN SMITH M.D. (CEO)
(707) 938-1040
Entity
Organization
Contact information
Practice address
181 ANDRIEUX ST, SUITE 107, SONOMA, CA 95476-6932
(707) 938-1040
(707) 938-0942
Mailing address
181 ANDRIEUX ST, SUITE 107, SONOMA, CA 95476-6932
(707) 938-1040
(707) 938-0942
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G92350
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341912042
RAILROAD PTAN
—
05
—
G92350
—
CA
Enumeration date
10/03/2007
Last updated
02/18/2009
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