Spruce, Wayne Ellsworth

Spruce, Wayne Ellsworth is an individual health care provider with primary practice located at 6160 Mission Gorge Rd Suite 400, San Diego CA 92120-3410. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Spruce, Wayne Ellsworth can be contacted via phone (619) 528-4010.

Contact Information

Primary practice address
6160 Mission Gorge Rd Suite 400 San Diego CA 92120-3410
Phone: (619) 528-4010
Fax: (619) 528-4077
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X A24022 California

Profile Details

NPI number 1780761320
LBN Legal business name Spruce, Wayne Ellsworth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 13th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780761320 NPPES
California MEDICAID 00A240220

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