Healthcare Provider Details

I. General information

NPI: 1851357545
Provider Name (Legal Business Name): CHRISTOPHER SCOTT SPENCER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W AVENUE J
LANCASTER CA
93534-2814
US

IV. Provider business mailing address

PO BOX 12380
WESTMINSTER CA
92685-2380
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-5000
  • Fax:
Mailing address:
  • Phone: 800-592-6829
  • Fax: 562-468-0347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG45684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: