Basic Information
Provider Information
NPI: 1245322684
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SPURRIER
FirstName: JULIET
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BACIOCCO
OtherFirstName: JULIET
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 10000
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943030985
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 795 EL CAMINO REAL
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943012302
CountryCode: US
TelephoneNumber: 6503214121
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/29/2006
LastUpdateDate: 10/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0204XA77528CAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine

No ID Information.


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