Healthcare Provider Details

I. General information

NPI: 1790717965
Provider Name (Legal Business Name): ERIK C. SPAYDE, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 SAINT CHARLES DR SUITE 200
THOUSAND OAKS CA
91360-3903
US

IV. Provider business mailing address

558 SAINT CHARLES DR SUITE 200
THOUSAND OAKS CA
91360-3903
US

V. Phone/Fax

Practice location:
  • Phone: 805-379-2322
  • Fax: 805-379-2373
Mailing address:
  • Phone: 805-379-2322
  • Fax: 805-379-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIK C SPAYDE
Title or Position: OWNER
Credential: MD
Phone: 805-379-2322