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NPI Code Detail

MEDICARE: DR. SCOTT IMAHARA MD

MEDICARE: DR. SCOTT IMAHARA MD
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
1208200000XPlastic Surgery PhysicianMD00042476WA

General Provider Information

NPI Number : 1740391176
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT IMAHARA MD
Provider Business Mailing Address
First Line : 2025 SOQUEL AVE
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062-1323
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2950 RESEARCH PARK DR
Second Line :
City : SOQUEL
State : CA
Zip : 95073-2000
Country : US
Telephone Number : 831-458-6272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/05/2012

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Directions to “ DR. SCOTT IMAHARA MD” Practice Location

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