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General NPI Number Information
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NPI Number | 1780987107
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Entity Type | Individual
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Provider Name | PATRICIA SPACCIAPOLLI PT
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Gender | Female
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 16980 VIA TAZON 100
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City | SAN DIEGO
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State | CA
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Zip | 92127-1633
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Country | US
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Telephone | 858-345-4114
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Fax | 866-920-8576
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Provider Business Mailing Address
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Address Line | 16980 VIA TAZON 100
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City | SAN DIEGO
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State | CA
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Zip | 92127-1633
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Country | US
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Telephone | 858-345-4114
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Fax | 866-920-8576
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 12973
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License Number State | CA
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