Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | G067672 | CA |
NPI | 1669491197 |
---|---|
Provider Name | Dr. Linda K Spitz |
First Address | Tustin, CA 92781-3903 |
Second Address | Irvine, CA 92612-4684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 12/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E72961 | (02) | CA |