Provider Demographics
NPI:1609818822
Name:SPAYDE, ERIK C (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:C
Last Name:SPAYDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:558 SAINT CHARLES DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-3903
Mailing Address - Country:US
Mailing Address - Phone:805-379-2322
Mailing Address - Fax:805-379-2373
Practice Address - Street 1:558 SAINT CHARLES DR
Practice Address - Street 2:SUITE 200
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-3903
Practice Address - Country:US
Practice Address - Phone:805-379-2322
Practice Address - Fax:805-379-2373
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90130207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5864130001Medicare NSC
I45259Medicare UPIN