Smith, Robert J

Smith, Robert J is an individual health care provider with primary practice located at 1405 Montgomery Dr , Santa Rosa CA 95405-4557. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Smith, Robert J can be contacted via phone (707) 546-1922.

Contact Information

Primary practice address
1405 Montgomery Dr Santa Rosa CA 95405-4557
Phone: (707) 546-1922
Fax: (707) 546-1897
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA20267 California

Profile Details

NPI number 1477765931
LBN Legal business name Smith, Robert J
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2007
Last updated Dec 3rd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477765931 NPPES
California MEDICAID PA20267
California Other 0PA202670
California Other PA20267

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