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General NPI Number Information
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NPI Number | 1205075223
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Entity Type | Individual
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Provider Name | EDWARD LEE SPENCER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2009
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 450 N BEDFORD DR STE 309
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4307
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Country | US
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Telephone | 310-425-3820
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Fax | 855-729-4884
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Provider Business Mailing Address
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Address Line | 450 N BEDFORD DR STE 309
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4307
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Country | US
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Telephone | 310-425-3820
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Fax | 855-729-4884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 79673
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A106729
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License Number State | CA
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