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Dr. Bradley P. Smith
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Bradley P. Smith |
| Gender: | M |
| Provider License Number If Given: | G56417 |
NPI Information:
| NPI: | 1619961117 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 12/29/2011 |
Provider Business Mailing Address:
| Address: | 275 N. EL CIELO Palm Springs, CA 92262 |
| Phone Number: | 7603238657 |
| Fax Number: | 7603189083 |
Provider Business Practice Location Address:
| Address: | 275 N. EL CIELO Palm Springs, CA 92262 |
| Phone Number: | 7603238657 |
| Fax Number: | 7603189083 |
Provider Taxonomy:
| Primary: | 208D00000X |
| Secondary (if any): | |
| State: | CA |
