Healthcare Provider Details

I. General information

NPI: 1174454599
Provider Name (Legal Business Name): ERIK C. SPAYDE, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 NEWBURY RD
THOUSAND OAKS CA
91320-6434
US

IV. Provider business mailing address

1001 NEWBURY RD
THOUSAND OAKS CA
91320-6434
US

V. Phone/Fax

Practice location:
  • Phone: 805-379-2322
  • Fax: 805-379-2322
Mailing address:
  • Phone: 805-379-2322
  • Fax: 805-379-2322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MONICA FANDINO
Title or Position: SUPERVISOR
Credential:
Phone: 805-379-2322