MEDICARE: DR. SPERO CHRISTI HORINE DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E-1333	CA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	P-180	ID

General Provider Information

NPI Number	:	1639174303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SPERO CHRISTI HORINE DPM

Provider Business Mailing Address
First Line	:	2505 SAMARITAN DR
Second Line	:	STE 509
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4015
Country	:	US
Telephone Number	:	408-358-2666
Fax Number	:	408-358-7974

Provider Business Practice Location Address
First Line	:	2505 SAMARITAN DR
Second Line	:	STE 509
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4015
Country	:	US
Telephone Number	:	408-358-2666
Fax Number	:	408-358-7974

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	03/10/2008

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