Healthcare Provider Details

I. General information

NPI: 1356837538
Provider Name (Legal Business Name): ELIZABETH SPITERI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WELCH RD
PALO ALTO CA
94304-1805
US

IV. Provider business mailing address

901 VARIAN WAY
PALO ALTO CA
94304-2406
US

V. Phone/Fax

Practice location:
  • Phone: 310-597-1278
  • Fax:
Mailing address:
  • Phone: 310-597-1278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SC0300X
TaxonomyClinical Cytogenetics Physician
License NumberDRM00000069
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207SG0203X
TaxonomyClinical Molecular Genetics Physician
License NumberDRN01008845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: