LaMarcus Aldridge and Jakob Poeltl each had 14 points and eight rebounds for the Spurs, who avenged a Wednesday loss to the Lakers, Sky Sports reported.
Patty Mills also scored 14 points for San Antonio, and Davis Bertans added 13.
Bryn Forbes and Marco Belinelli contributed 11 points apiece and Rudy Gay added 10 for San Antonio, who outscored Los Angeles 44-21 in the fourth quarter.
LeBron James had 35 points, 11 assists and eight rebounds, and Kyle Kuzma added 27 points and eight rebounds for the Lakers, who had a four-game winning streak halted.
Los Angeles played without small forward Brandon Ingram, who sprained his left ankle in the Wednesday game.
Bertans knocked down four three-pointers as the Spurs made 13 of 31 from three-point range and shot 50.5 percent overall.
The Lakers shot 46 percent from the floor and made 11-of-36 from long range.
San Antonio trailed for the entire second and third quarters, falling behind by as much as 15 points, before making a late dash.
The Spurs used a 9-0 run – capped by Bertans' three-pointer with 4:48 left – to take a 118-112 lead.
A short time later, DeRozan hit three consecutive shots as San Antonio took a 127-116 advantage with 2:10 remaining.
Another three-pointer by Bertans pushed the lead to 131-118 with 1:34 left, and the Spurs closed it out.