Healthcare Provider Details

I. General information

NPI: 1669491197
Provider Name (Legal Business Name): LINDA K SPITZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA R KAPLAN MD

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4199 CAMPUS DR SUITE 550
IRVINE CA
92612-4684
US

IV. Provider business mailing address

PO BOX 3903
TUSTIN CA
92781-3903
US

V. Phone/Fax

Practice location:
  • Phone: 949-509-6506
  • Fax: 949-509-6507
Mailing address:
  • Phone: 949-509-6506
  • Fax: 949-509-6507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberG067672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: