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General NPI Number Information
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NPI Number | 1144860651
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Entity Type | Individual
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Provider Name | DAVID COOPER SMITH FNP-BC, PHN, CNL
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Gender | Male
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 81719 DR CARREON BLVD STE A
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City | INDIO
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State | CA
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Zip | 92201-5518
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Country | US
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Telephone | 760-340-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 82879 KINGSBORO LN
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City | INDIO
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State | CA
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Zip | 92201-9667
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Country | US
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Telephone | 415-341-7742
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP95032693
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License Number State | CA
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