Spencer, Dale R.
Spencer, Dale R. is an sole proprietor health care provider with primary practice located at 704 N State St , Ukiah CA 95482-3408. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Spencer, Dale R. can be contacted via phone (707) 462-2602.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5466T | California |
Profile Details
| NPI number | 1457312795 |
|---|---|
| LBN Legal business name | Spencer, Dale R. |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457312795 | NPPES |
| California | MEDICAID | SD0054660 |
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