Healthcare Provider Details

I. General information

NPI: 1609860709
Provider Name (Legal Business Name): SCOTT E ADAMS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 04/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S HALCYON RD SUITE 101
ARROYO GRANDE CA
93420-3872
US

IV. Provider business mailing address

310 S HALCYON RD SUITE 101
ARROYO GRANDE CA
93420-3872
US

V. Phone/Fax

Practice location:
  • Phone: 805-481-0881
  • Fax: 805-481-0835
Mailing address:
  • Phone: 805-481-0881
  • Fax: 805-481-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: