Provider Demographics
NPI:1780877704
Name:JOSEPH T. SPAULDING, M.D. INC
Entity type:Organization
Organization Name:JOSEPH T. SPAULDING, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-785-4246
Mailing Address - Street 1:909 HYDE ST
Mailing Address - Street 2:STE 222
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4822
Mailing Address - Country:US
Mailing Address - Phone:415-441-3155
Mailing Address - Fax:415-441-4075
Practice Address - Street 1:909 HYDE ST
Practice Address - Street 2:STE 222
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4822
Practice Address - Country:US
Practice Address - Phone:415-441-3155
Practice Address - Fax:415-441-4075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA237900208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A237900Medicaid
CA00A237900Medicaid
CA00A237900Medicare PIN