Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | G57371 | CA |
NPI | 1093075129 |
---|---|
Provider Name | Dr. Lawrence I. Spinner |
First Address | Thousand Oaks, CA 91360-3003 |
Second Address | Thousand Oaks, CA 91360-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2012 |
Last Update Date | 30/05/2012 |