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Individual

DR. JOSHUA PAUL SPANOGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2290 SACRAMENTO ST, VALLEJO, CA 94590-2929
(707) 643-5785
(707) 643-8810
Mailing address
2290 SACRAMENTO ST, VALLEJO, CA 94590-2929
(707) 643-5785
(707) 643-8810

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
51287
MN
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
A116055
CA
207NS0135X
Procedural Dermatology Physician
A116055
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
MN
01
P00773912
MEDICARE, RAILROAD
MN
Enumeration date
12/17/2007
Last updated
03/10/2014
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