Provider Demographics
NPI:1992481089
Name:SPEARS BABCOCK DO PC
Entity type:Organization
Organization Name:SPEARS BABCOCK DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEARS BABCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:805-379-9911
Mailing Address - Street 1:23242 HATTERAS ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3118
Mailing Address - Country:US
Mailing Address - Phone:805-379-9911
Mailing Address - Fax:805-379-0557
Practice Address - Street 1:325 ROLLING OAKS DR STE 220
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1085
Practice Address - Country:US
Practice Address - Phone:805-379-9911
Practice Address - Fax:805-379-0557
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPEARS BABCOCK DO PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-23
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty