Healthcare Provider Details

I. General information

NPI: 1770885154
Provider Name (Legal Business Name): JOHN D.. SMILEY PHARM.DR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 STRATFORD AVE
DIXON CA
95620-2024
US

IV. Provider business mailing address

1235 STRATFORD AVE
DIXON CA
95620-2024
US

V. Phone/Fax

Practice location:
  • Phone: 707-678-7402
  • Fax: 707-678-7405
Mailing address:
  • Phone: 707-678-7402
  • Fax: 707-678-7405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: