SPENCER RODRIGUEZ PODIATRY CORPORATION NPI 1619396884

NPI Information

NPI: 1619396884
Provider Name: SPENCER RODRIGUEZ PODIATRY CORPORATION

Doing Business As: SOUTHERN CALIFORNIA FOOT AND ANKLE SPECIALISTS

Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
333 CORPORATE DR STE 230
LADERA RANCH, CA
ZIP 92694
Phone: (949) 364-9255
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SPENCER RODRIGUEZ PODIATRY CORPORATION is a foot and ankle surgery podiatrist in Ladera Ranch, CA. SPENCER RODRIGUEZ PODIATRY CORPORATION NPI is 1619396884. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Southern California Foot And Ankle Specialists.

The provider's business location address is:

333 CORPORATE DR STE 230
LADERA RANCH, CA
ZIP 92694-180
Phone: (949) 364-9255
Fax: (949) 364-9250

The provider's authorized official is Robert J Spencer .
The authorized official title is Co-founder and has the following contact phone number (714) 488-0666.

The CLIA number assigned to this NPI record is 05D1014199 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/15/2014 and was last updated on 2/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	E4790	CALIFORNIA	Yes
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	E4828	CALIFORNIA	No
3	261QP1100X	Clinic/Center	Podiatric			No

What is NPI?

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This page was last updated on: 5/5/2024

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