Provider Demographics
NPI:1386869493
Name:SPENSER, CIPRIAN RAOUL (MD)
Entity type:Individual
Prefix:
First Name:CIPRIAN
Middle Name:RAOUL
Last Name:SPENSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W LINCOLN AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2993
Mailing Address - Country:US
Mailing Address - Phone:714-520-7300
Mailing Address - Fax:714-520-0883
Practice Address - Street 1:303 W LINCOLN AVE STE 130
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2993
Practice Address - Country:US
Practice Address - Phone:714-520-7300
Practice Address - Fax:714-520-0883
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA995092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry