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NPI Code Detail

MEDICARE: JOSEPH MICHAEL SMURDA

MEDICARE:   JOSEPH MICHAEL SMURDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianA67100CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100A671000OTHERCAMEDICAL

General Provider Information

NPI Number : 1053428706
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH MICHAEL SMURDA
Provider Business Mailing Address
First Line : 12300 WILSHIRE BLVD
Second Line : SUITE 330
City : LOS ANGELES
State : CA
Zip : 90025-1020
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12300 WILSHIRE BLVD
Second Line : SUITE 330
City : LOS ANGELES
State : CA
Zip : 90025-1020
Country : US
Telephone Number : 310-820-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 07/08/2007

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Directions to “ JOSEPH MICHAEL SMURDA ” Practice Location

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