Provider Demographics
NPI:1487630109
Name:SPITLER, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:SPITLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 SEABRIGHT AVE STE B2
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2555
Mailing Address - Country:US
Mailing Address - Phone:831-800-1313
Mailing Address - Fax:831-385-5940
Practice Address - Street 1:1509 SEABRIGHT AVE STE B2
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2555
Practice Address - Country:US
Practice Address - Phone:831-800-1313
Practice Address - Fax:831-800-1313
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53654207L00000X, 207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG536540Medicaid
CAG536540Medicaid
CAE28506Medicare UPIN