Individual
GREGORY B. SPIVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23880 SCARLET OAK DR, MURRIETA, CA 92562-5084
(951) 399-5023
Mailing address
23880 SCARLET OAK DR, MURRIETA, CA 92562-5084
(951) 399-5023
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N3830164
DRIVER LICENSE
CA
Enumeration date
01/22/2021
Last updated
01/22/2021
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