NPI 1023786746

Willie Smith

Practitioner Driver San Jose, CA

Practice location

Address: 1265 N Capitol Ave APT 90, San Jose, CA 95132-2546
Phone: (408) 886-8070

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence A4709810 (CA)

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Registry record

NPI: 1023786746
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Aug 2021
Record last updated: 30 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.