Provider Demographics
NPI:1396030292
Name:SPEKTOR, MAXIM (DO)
Entity Type:Individual
Prefix:DR
First Name:MAXIM
Middle Name:
Last Name:SPEKTOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:57445 29 PALMS HWY
Mailing Address - Street 2:STE 301
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2947
Mailing Address - Country:US
Mailing Address - Phone:760-498-5349
Mailing Address - Fax:760-418-4638
Practice Address - Street 1:57445 29 PALMS HWY
Practice Address - Street 2:STE 301
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2947
Practice Address - Country:US
Practice Address - Phone:760-498-5349
Practice Address - Fax:760-418-4638
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2021-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY276290-1208600000X
CA20A14822208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery