Individual
GARRAN ALEXANDER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8014 MANGO AVE, APT F75, FONTANA, CA 92336-3352
(909) 900-7710
Mailing address
8014 MANGO AVE, APT F75, FONTANA, CA 92336-3352
(909) 900-7710
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000000
—
CA
Enumeration date
04/28/2014
Last updated
04/28/2014
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