Healthcare Provider Details

I. General information

NPI: 1871554162
Provider Name (Legal Business Name): IRENE M SPINELLO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 FLOWER ST 144
BAKERSFIELD CA
93305-4144
US

IV. Provider business mailing address

PO BOX 21105
BAKERSFIELD CA
93390-1105
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-2200
  • Fax: 661-326-2100
Mailing address:
  • Phone: 661-665-1600
  • Fax: 661-665-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA66730
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA66730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: