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General NPI Number Information
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NPI Number | 1932274487
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Entity Type | Individual
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Provider Name | SAM SPENCER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 326 ENCINITAS BLVD STE 100
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City | ENCINITAS
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State | SAN DIEGO
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Zip | 92024-8703
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Country | UM
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Telephone | 760-436-5533
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Fax | 760-436-0611
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Provider Business Mailing Address
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Address Line | 326 ENCINITAS BLVD STE100
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City | ENCINITAS
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State | CA
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Zip | 92024-8703
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Country | US
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Telephone | 760-436-5533
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Fax | 760-436-0611
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4621
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License Number State | CA
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