MARY SPENCER-SMITH M.D. NPI 1790714020

NPI Information

NPI: 1790714020
Provider Name: MARY SPENCER-SMITH, M.D.
Classification: Radiology - 2085B0100X
Entity Type: Individual

Specialization: Body Imaging

PECOS Registration: Yes

Address:
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA
ZIP 90033
Phone: (626) 795-1610
Get Directions

Mary Spencer-smith, M.D. is a body imaging radiology in Los Angeles, CA. The provider is a Radiology doctor of Osteopathy that specializes in Body Imaging. Mary Spencer-smith, M.D. NPI is 1790714020. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA
ZIP 90033-414
Phone: (626) 795-1610
Fax: (626) 795-0751

The NPI 1790714020 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/30/2006 and was last updated on 7/8/2007.

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	2085B0100X	Radiology	Body Imaging	G51245	CALIFORNIA	Yes
2	2085N0700X	Radiology	Neuroradiology	G51245	CALIFORNIA	X
3	2085N0904X	Radiology	Nuclear Radiology	G51245	CALIFORNIA	X
4	2085P0229X	Radiology	Pediatric Radiology	G51245	CALIFORNIA	X
5	2085R0202X	Radiology	Diagnostic Radiology	G51245	CALIFORNIA	X
6	2085U0001X	Radiology	Diagnostic Ultrasound	G51245	CALIFORNIA	X

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
1	WG51245A	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA

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: 4/28/2024

NPI Synchronization or Removal

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