MEDICARE: DR. JOHN R. SPURZEM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	G89192	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01081272	OTHER	MS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467489930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN R. SPURZEM MD

Provider Business Mailing Address
First Line	:	523 SAN PEDRO CV
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-2478
Country	:	US
Telephone Number	:	601-209-8064
Fax Number	:

Provider Business Practice Location Address
First Line	:	3260 KERNER BLVD
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-4840
Country	:	US
Telephone Number	:	415-448-1500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/30/2024

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