Spartamed

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

103-035557 Issued in CA

Legal business name

SPARTAMED

Practice address

1511 W Alton Ave
Santa Ana, CA 92704-7219

Phone

(949) 632-0355

NPI assigned

Jul 24, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Trevor Theriot

Title

President

Phone

(657) 266-0069

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500854400000",
    "number": "1467975284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 W ALTON AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047219",
            "telephone_number": "657-266-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 W ALTON AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047219",
            "telephone_number": "949-632-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTAMED",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2017-07-24",
        "status": "A",
        "authorized_official_last_name": "THERIOT",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "657-266-0069"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "103-035557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Praseuth Souvannavong
• Soyeon Kim
• Anissa Ellen Spada, NURSE PRACTITIONER
• Sheena Marie Spanskie, APRN-PMHNP
• Tina Sparks
• John A Spear, D.D.S.
• Damien Joseph Spena
• Guadalupe Spencer
• Niara Spencer
• Robert S Sperduti, D.C.

• Non-Pharmacy Dispensing Site in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.