SPENCER RODRIGUEZ PODIATRY CORPORATION NPI 1619396884

NPI Information

  • NPI: 1619396884
  • Provider Name: SPENCER RODRIGUEZ PODIATRY CORPORATION
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Doing Business As: SOUTHERN CALIFORNIA FOOT AND ANKLE SPECIALISTS
  • CLIA Number: 05D1014199
  • Address: 333 CORPORATE DR STE 230
    LADERA RANCH, CA
    ZIP 92694
  • Phone: (949) 364-9255

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NPI Details

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 6/11/2024.

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
1213ES0103XPodiatristFoot & Ankle SurgeryE4828CALIFORNIANo
2213ES0103XPodiatristFoot & Ankle SurgeryE4790CALIFORNIAYes
3261QP1100XClinic/CenterPodiatricNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11790309672OTHERCALIFORNIAMEDICARE
21982751632OTHERCALIFORNIAMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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