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General NPI Number Information
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NPI Number | 1780617217
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Entity Type | Individual
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Provider Name | Y LENNY SPIVAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 342 N VERMONT AVE
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City | DINUBA
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State | CA
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Zip | 93618-1631
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Country | US
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Telephone | 559-591-7229
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Fax | 559-596-2085
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Provider Business Mailing Address
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Address Line | PO BOX 28915
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City | FRESNO
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State | CA
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Zip | 93729-8915
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Country | US
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Telephone | 559-253-2800
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Fax | 559-596-2085
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A44707
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License Number State | CA
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