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Physician Compare National (NPI:1659453611)

HEALTHCARE PROVIDER: HOLLY SPOHN-GROSS DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1659453611
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 6103875919
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20050119000750
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name SPOHN GROSS
Individual professional last name
Provider First Name HOLLY
Individual professional first name
Provider Middle Name A
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.
Provider Credential Text DPM
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1997
Individual professional's medical school graduation year
Primary Specialty PODIATRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 6425 LYNCH CANYON DR
Group Practice or individual's line 1 address
City LAKE ISABELLA
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 932409726
Group Practice or individual's zip code (9 digits when available)
Phone Number 760379863027
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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