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General NPI Number Information
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NPI Number | 1902387293
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Entity Type | Individual
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Provider Name | CHADWYCKE RICHARD SMITH NP, AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1520 SAN PABLO ST STE 3800
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City | LOS ANGELES
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State | CA
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Zip | 90033-5328
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Country | US
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Telephone | 323-442-5720
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31309
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City | LOS ANGELES
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State | CA
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Zip | 90031-0309
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Country | US
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Telephone | 323-442-5720
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 841328
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 841328
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95009361
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License Number State | CA
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