MEDICARE: SCOTT E ADAMS DPM 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	332B00000X	Durable Medical Equipment & Medical Supplies	0600250001	CA
2	213E00000X	Podiatrist	40580	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DG7094	OTHER	CA	RAILRIOAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	ZZZ50260Y	OTHER	CA	BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487648697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT E ADAMS DPM INC

Provider Business Mailing Address
First Line	:	310 S HALCYON RD
Second Line	:	SUITE 101
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-3872
Country	:	US
Telephone Number	:	805-481-0881
Fax Number	:	805-481-0835

Provider Business Practice Location Address
First Line	:	310 S HALCYON RD
Second Line	:	SUITE 101
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-3872
Country	:	US
Telephone Number	:	805-481-0881
Fax Number	:	805-481-0835

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SCOTT E. ADAMS
Credential	:	D.P.M.
Telephone Number	:	805-481-0881

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	06/01/2015

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