Provider Demographics
NPI:1730524786
Name:SPINDELILUS, EARENDIL MYCAL (DNM, MH CR)
Entity type:Individual
Prefix:MR
First Name:EARENDIL
Middle Name:MYCAL
Last Name:SPINDELILUS
Suffix:
Gender:M
Credentials:DNM, MH CR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:IGO
Mailing Address - State:CA
Mailing Address - Zip Code:96047-0266
Mailing Address - Country:US
Mailing Address - Phone:530-722-6728
Mailing Address - Fax:
Practice Address - Street 1:3310 CHURN CREEK RD
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2502
Practice Address - Country:US
Practice Address - Phone:530-722-6728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 174H00000X, 175F00000X
UT173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No173C00000XOther Service ProvidersReflexologist
No174H00000XOther Service ProvidersHealth Educator