MEDICARE: DR. SCOTT GREGORY DPT, OCS

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	2251X0800X	Orthopedic Physical Therapist	PT28389	CA

General Provider Information

NPI Number	:	1275596512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT GREGORY DPT, OCS

Provider Business Mailing Address
First Line	:	5 QUINCY AVE APT B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-7402
Country	:	US
Telephone Number	:	310-570-8424
Fax Number	:	562-548-7656

Provider Business Practice Location Address
First Line	:	5 QUINCY AVE APT B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-7402
Country	:	US
Telephone Number	:	310-570-8424
Fax Number	:	562-548-7656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	11/25/2025

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