| Doctor Name: | SPENCER KULICK |
| NPI Number: | 1235117839 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., F.A.C.C. |
| License Number: | G29073 |
| Business Practice Address: | 1941 Johnson Ave # 101 San Luis Obispo, CA - 93401 |
| Business Phone Number: | 8057828844 |
| Business Fax Number: | 8057828859 |
| Mailing Address: | 1941 Johnson Ave, # 101 SAN LUIS OBISPO |
| State: | CA |
| Postal Code: | 934014140 |
| Phone Number: | 8057828844 |
| Fax Number: | 8057828859 |
| NPI Enumeration Date: | 01/04/2006 |
| NPI Last Update Date: | 09/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | G29073 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |