Individual
MR. ROBERT A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO
Contact information
Practice address
190 N WIGET LANE, SUITE 109, WALNUT CREEK, CA 94598-2417
(925) 935-9194
(925) 935-9194
Mailing address
190 N WIGET LANE, SUITE 109, WALNUT CREEK, CA 94598-2417
(925) 935-9194
(925) 935-9194
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CO002952
—
224P00000X
Prosthetist
—
—
225000000X
Orthotic Fitter
—
—
246Z00000X
Other Specialist/Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XA0029520
—
CA
Enumeration date
02/01/2011
Last updated
03/21/2013
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