Individual
DR. THOMAS J SPILLANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 TANK FARM ROAD, SUITE C, SAN LUIS OBISPO, CA 93401-7068
(805) 543-5577
(805) 595-3231
Mailing address
715 TANK FARM RD STE C, SAN LUIS OBISPO, CA 93401-7068
(805) 543-5577
(805) 595-3231
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
G79734
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G797340
BLUE SHIELD PIN
CA
05
—
00G797340
—
CA
01
—
1018
CMSP PIN
CA
01
—
CA164416
MEDICARE ID
CA
01
—
S113351
INTEGRATED HEALTH PLAN PI
—
Enumeration date
06/16/2005
Last updated
11/08/2023
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