Organization
DAVID M TULLY SMITH M D A MEDICAL CORPORATION
Active
Other names
Mill Valley Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA TULLY-SMITH (VICE PRESIDENT)
(707) 544-2632
Entity
Organization
Contact information
Practice address
711 D ST, SUITE 111, SAN RAFAEL, CA 94901-3707
(415) 453-3030
Mailing address
PO BOX 3137, ROHNERT PARK, CA 94927-3137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G30229
CA
Other
Enumeration date
02/17/2007
Last updated
11/07/2008
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