Healthcare Provider Details

I. General information

NPI: 1952637282
Provider Name (Legal Business Name): DARIUS TERRENCE SPENCER P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N BRENT ST
VENTURA CA
93003-2854
US

IV. Provider business mailing address

PO BOX 920125
DALLAS TX
75392-0143
US

V. Phone/Fax

Practice location:
  • Phone: 888-388-7206
  • Fax:
Mailing address:
  • Phone: 877-346-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: