Provider Demographics
NPI:1982751632
Name:SPENCER, ROBERT JAMES (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:SPENCER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:27800 MEDICAL CENTER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6410
Mailing Address - Country:US
Mailing Address - Phone:949-364-9255
Mailing Address - Fax:949-364-9250
Practice Address - Street 1:333 CORPORATE DR STE 230
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-2180
Practice Address - Country:US
Practice Address - Phone:949-364-9255
Practice Address - Fax:949-364-9250
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAEL1670213ES0103X
CAE4828213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE4828OtherSTATE MEDICAL LICENSE