Provider Demographics
NPI:1477580892
Name:SPECTOR, TODD J (MD)
Entity Type:Individual
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First Name:TODD
Middle Name:J
Last Name:SPECTOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-586-9001
Mailing Address - Fax:310-586-9050
Practice Address - Street 1:2001 SANTA MONICA BLVD
Practice Address - Street 2:370W
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2102
Practice Address - Country:US
Practice Address - Phone:310-586-9001
Practice Address - Fax:310-586-9051
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2014-04-23
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Provider Licenses
StateLicense IDTaxonomies
CAA76233207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA76233BMedicare PIN
CAH87160Medicare UPIN