Basic Information
| Provider Information | |||||||||
| NPI: | 1487630109 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPITLER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1509 SEABRIGHT AVE STE B2 | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950622555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8318001313 | ||||||||
| FaxNumber: | 8313855940 | ||||||||
| Practice Location | |||||||||
| Address1: | 1509 SEABRIGHT AVE STE B2 | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950622555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8318001313 | ||||||||
| FaxNumber: | 8318001313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2005 | ||||||||
| LastUpdateDate: | 05/02/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | G53654 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LA0401X | G53654 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Addiction Medicine |
ID Information
| ID | Type | State | Issuer | Description | G536540 | 05 | CA | MEDICAID |