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General NPI Number Information
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NPI Number | 1407879596
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Entity Type | Individual
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Provider Name | DAVID RICHARD WYNDHAMSMITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 1509 WILSON TER
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City | GLENDALE
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State | CA
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Zip | 91206-4007
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Country | US
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Telephone | 818-409-8000
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Fax | 818-546-5632
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Provider Business Mailing Address
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Address Line | PO BOX 60790
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City | PASADENA
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State | CA
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Zip | 91116-6790
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Country | US
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Telephone | 626-204-6747
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Fax | 626-396-0851
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G72018
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License Number State | CA
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