Active NPI
Walter Spears, M.D.
- Family Medicine Physician
- Pasadena, CA
National Provider Identifier
1205809704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G34441
- Practice address
- 2595 E Washington Blvd
107
Pasadena, CA 91107-1409 - Phone
- (626) 791-1168
- Fax
- (626) 791-4737
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G34441 | CA | Primary |
Addresses
Primary practice location
2595 E Washington Blvd
107
Pasadena, CA 91107-1409
Mailing address
2595 E Washington Blvd
107
Pasadena, CA 91107-1409
Phone (626) 791-1168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G344410 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G34441 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191196800000",
"number": "1205809704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2595 E WASHINGTON BLVD",
"address_2": "107",
"city": "PASADENA",
"state": "CA",
"postal_code": "911071409",
"telephone_number": "626-791-1168",
"fax_number": "626-791-4737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2595 E WASHINGTON BLVD",
"address_2": "107",
"city": "PASADENA",
"state": "CA",
"postal_code": "911071409",
"telephone_number": "626-791-1168",
"fax_number": "626-791-4737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEARS",
"first_name": "WALTER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2007-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G34441",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G344410",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.