Individual
MS. RHONDA MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1300 MABLE AVENUE, SUITE 2, MODESTO, CA 95355
(209) 571-1992
(209) 571-1994
Mailing address
1300 MABLE AVENUE, SUITE 2, MODESTO, CA 95355
(209) 571-1992
(209) 571-1994
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA14435
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA14435
PA LICENSE
CA
Enumeration date
05/22/2008
Last updated
11/28/2012
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