Provider Demographics
NPI:1144435223
Name:SPEARMAN, MICHAEL S (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:SPEARMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 N BERENDO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1601
Mailing Address - Country:US
Mailing Address - Phone:323-663-1066
Mailing Address - Fax:
Practice Address - Street 1:1279 N BERENDO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1601
Practice Address - Country:US
Practice Address - Phone:323-663-1066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24621111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346406527OtherNPI-2
CADC24621OtherMEDICARE ID (PTAN)
CADC24621OtherMEDICARE ID (PTAN)
CA1346406527OtherNPI-2