Provider Demographics
NPI:1669491197
Name:SPITZ, LINDA K (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:K
Last Name:SPITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:R
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3903
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92781-3903
Mailing Address - Country:US
Mailing Address - Phone:949-509-6506
Mailing Address - Fax:949-509-6507
Practice Address - Street 1:4199 CAMPUS DR
Practice Address - Street 2:SUITE 550
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-4684
Practice Address - Country:US
Practice Address - Phone:949-509-6506
Practice Address - Fax:949-509-6507
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG067672204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE72961Medicare UPIN
CAG067672Medicare ID - Type Unspecified