Provider Demographics
NPI:1821037367
Name:SPENCER, CHARLENE B (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:B
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:801 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3871
Mailing Address - Country:US
Mailing Address - Phone:925-946-1080
Mailing Address - Fax:925-946-9717
Practice Address - Street 1:801 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 250
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3871
Practice Address - Country:US
Practice Address - Phone:925-946-1080
Practice Address - Fax:925-946-9717
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG83176208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H09701Medicare UPIN
00G831762Medicare ID - Type Unspecified