Provider Demographics
NPI:1770631715
Name:SMITH, BRIAN R (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:R
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:333 CITY BLVD W
Mailing Address - Street 2:SUITE 850
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2903
Mailing Address - Country:US
Mailing Address - Phone:714-456-8598
Mailing Address - Fax:714-456-6027
Practice Address - Street 1:333 CITY BLVD W
Practice Address - Street 2:SUITE 850
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2903
Practice Address - Country:US
Practice Address - Phone:714-456-8598
Practice Address - Fax:714-456-6027
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2013-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA80196208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery