Spencer Palache

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · San Fernando, CA

NPI 1639711658 · NPPES record last updated Apr 29, 2021

Key facts

NPI
1639711658
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
919 1St St
San Fernando, CA 91340-2957
Phone
(818) 256-1124
NPI assigned
Oct 10, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

919 1St St
San Fernando, CA 91340-2957

Mailing address

919 1St St
San Fernando, CA 91340-2957
Phone (818) 256-1124

Other providers in San Fernando, CA

All providers in San Fernando, CA · Student in an Organized Health Care Education/Training Program in California

Sources for this page

Verify at the official NPI Registry.