Provider Demographics
NPI:1447076245
Name:SPURGEON, MARY LOUISE (RDMS)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LOUISE
Last Name:SPURGEON
Suffix:
Gender:F
Credentials:RDMS
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Mailing Address - Street 1:9700 EL CAMINO REAL STE 202
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-5579
Mailing Address - Country:US
Mailing Address - Phone:805-460-6611
Mailing Address - Fax:805-426-8318
Practice Address - Street 1:9700 EL CAMINO REAL STE 202
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5579
Practice Address - Country:US
Practice Address - Phone:805-460-6611
Practice Address - Fax:805-426-8318
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1540662471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty