Healthcare Provider Details

I. General information

NPI: 1578572897
Provider Name (Legal Business Name): ROBERT SENTELL SPEARS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MOWRY AVE
FREMONT CA
94538-1716
US

IV. Provider business mailing address

PO BOX V
MOUNTAIN VIEW CA
94040-0150
US

V. Phone/Fax

Practice location:
  • Phone: 510-797-1111
  • Fax:
Mailing address:
  • Phone: 650-691-0611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG65777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: