MEDICARE: VERONICA D SPENCER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	52513	CA

General Provider Information

NPI Number	:	1093196578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA D SPENCER PA-C

Provider Business Mailing Address
First Line	:	1000 SAN GABRIEL BLVD STE 200
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-4394
Country	:	US
Telephone Number	:	323-724-0019
Fax Number	:	323-248-7044

Provider Business Practice Location Address
First Line	:	308 W 6TH ST STE 109
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92882-3349
Country	:	US
Telephone Number	:	833-867-4642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2015
Last Update Date	:	06/01/2026

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Directions to “ VERONICA D SPENCER PA-C” Practice Location

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