Individual
CLAYTON N SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1000
Mailing address
244 S DALLAS AVE, SAN BERNARDINO, CA 92410-1964
(903) 724-6295
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95035744
CA
163WC0200X
Critical Care Medicine Registered Nurse
95035744
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95000498
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95000498
CERTIFIED REGISTERED NURSE ANESTHETIST
CA
01
—
95035744
CALIFORNIA REGISTERED NURSING LICENSE
CA
Enumeration date
11/03/2015
Last updated
03/14/2016
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