Individual
MR. PAUL ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
357 PISMO ST APT F, SAN LUIS OBISPO, CA 93401-6141
(805) 801-2512
(805) 549-9444
Mailing address
3940-7 BROAD ST. BOX 110, SAN LUIS OBISPO, CA 93401
(805) 801-2512
(805) 549-9444
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
440363
CA
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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