MEDICARE: SPENCER HEALTHCARE LLC

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1891117305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPENCER HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	2222 MARTIN
Second Line	:	SUITE 214
City	:	IRVINE
State	:	CA
Zip	:	92612-1458
Country	:	US
Telephone Number	:	949-464-4488
Fax Number	:	949-333-5377

Provider Business Practice Location Address
First Line	:	951 MARINERS ISLAND BLVD
Second Line	:	SUITE 300
City	:	SAN MATEO
State	:	CA
Zip	:	94404-1558
Country	:	US
Telephone Number	:	650-488-5590
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JEAN HUNN
Credential	:
Telephone Number	:	650-488-5590

Provider Enumeration Date	:	01/17/2014
Last Update Date	:	01/17/2014

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Directions to “SPENCER HEALTHCARE LLC ” Practice Location

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