Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G16681 | CA |
Y | 208600000X | Surgeon | G16681 | CA |
N | 2086S0129X | Vascular Surgeon | G16681 | CA |
NPI | 1063581098 |
---|---|
Provider Name | Dr. Lawrence J. Spingola |
First Address | Santa Cruz, CA 95065-1522 |
Second Address | Santa Cruz, CA 95065-1522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 18/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C98107 | (02) | CA |
GR0100250 | (05) | CA |