Provider Demographics
NPI:1871578021
Name:SPITZ, MARTIN JAY (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:JAY
Last Name:SPITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:108 AUTUMN RUN WAY
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6724
Mailing Address - Country:US
Mailing Address - Phone:707-226-7755
Mailing Address - Fax:707-226-3581
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-540-1027
Practice Address - Fax:415-750-3386
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG11391207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38340Medicare UPIN