Individual
ANDREW M SMYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2018 MISSION ST, SANTA CRUZ, CA 95060-5218
(831) 706-2220
(831) 425-2034
Mailing address
3400 DATA DR, ATTN CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A15748
CA
207Q00000X
Family Medicine Physician
PG167651
OR
Other
Enumeration date
04/08/2014
Last updated
11/02/2017
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