MEDICARE: B. SCOTT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC20396	CA

General Provider Information

NPI Number	:	1184972812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B. SCOTT, INC.

Provider Business Mailing Address
First Line	:	15550 ROCKFIELD BLVD STE B220
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-6703
Country	:	US
Telephone Number	:	949-598-9999
Fax Number	:	949-598-9990

Provider Business Practice Location Address
First Line	:	1447 SANTA FE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1249
Country	:	US
Telephone Number	:	562-437-9000
Fax Number	:	562-437-9001

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN SCOTT
Credential	:	D.C.
Telephone Number	:	949-598-9999

Provider Enumeration Date	:	08/28/2012
Last Update Date	:	08/28/2012

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