Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35095923 | OH |
N | 208600000X | Surgeon | 35095923 | OH |
N | 2082S0105X | Plastic Hand Surgeon | 35095923 | OH |
Y | 2082S0105X | Plastic Hand Surgeon | A103913 | CA |
N | 2086S0105X | Surgery of the Hand | A103913 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | A103913 | CA |
NPI | 1174738637 |
---|---|
Provider Name | Dr. Maya C Spaeth |
First Address | Riverside, CA 92501-4136 |
Second Address | Riverside, CA 92501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 24/10/2019 |