Healthcare Provider Details

I. General information

NPI: 1609256437
Provider Name (Legal Business Name): ZANI SPENCER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2015
Last Update Date: 06/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 E 154TH ST
COMPTON CA
90220-2500
US

IV. Provider business mailing address

827 E 154TH ST
COMPTON CA
90220-2500
US

V. Phone/Fax

Practice location:
  • Phone: 855-246-9663
  • Fax: 855-246-9663
Mailing address:
  • Phone: 855-246-9663
  • Fax: 855-246-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: