Basic Information
| Provider Information | |||||||||
| NPI: | 1528410586 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPAULDING | ||||||||
| FirstName: | ANDREA | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12555 LAKEWOOD BLVD | ||||||||
| Address2: | SUITE F | ||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902422771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629234704 | ||||||||
| FaxNumber: | 5629236709 | ||||||||
| Practice Location | |||||||||
| Address1: | 12555 LAKEWOOD BLVD | ||||||||
| Address2: | SUITE F | ||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902422771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629234704 | ||||||||
| FaxNumber: | 5629236709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2016 | ||||||||
| LastUpdateDate: | 07/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | PT291349 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.