Healthcare Provider Details

I. General information

NPI: 1114064342
Provider Name (Legal Business Name): LAURENE SPENCER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 E ST
FRESNO CA
93706-2024
US

IV. Provider business mailing address

1560 HAYNE RD
HILLSBOROUGH CA
94010-6757
US

V. Phone/Fax

Practice location:
  • Phone: 559-268-6261
  • Fax: 559-268-7518
Mailing address:
  • Phone: 415-928-7800
  • Fax: 415-928-3710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG45940
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: