Healthcare Provider Details

I. General information

NPI: 1104869056
Provider Name (Legal Business Name): SCOTT P. SLIGH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 W RIVERSIDE DR SUITE#400
BURBANK CA
91505-4325
US

IV. Provider business mailing address

3808 W RIVERSIDE DR SUITE#400
BURBANK CA
91505-4325
US

V. Phone/Fax

Practice location:
  • Phone: 818-848-8840
  • Fax: 818-848-0439
Mailing address:
  • Phone: 818-848-8840
  • Fax: 818-848-0439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA71225
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberA71225
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: