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Organization

SPENCER RODRIGUEZ PODIATRY CORPORATION

Active
Other names
Southern California Foot and Ankle Specialists
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT J SPENCER D.P.M. (CO-FOUNDER)
(714) 488-0666
Entity
Organization

Contact information

Practice address
333 CORPORATE DR STE 230, LADERA RANCH, CA 92694-2180
(949) 364-9255
(949) 364-9250
Mailing address
333 CORPORATE DR STE 230, LADERA RANCH, CA 92694-2180
(949) 364-9255
(949) 364-9250

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4790
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E4828
CA
261QP1100X
Podiatric Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1790309672
MEDICARE
CA
01
1982751632
MEDICARE
CA
Enumeration date
04/15/2014
Last updated
06/11/2024
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