Healthcare Provider Details
I. General information
NPI: 1699708206
Provider Name (Legal Business Name): SCOTT P. SLIGH, M.D., A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3808 W RIVERSIDE DR #400
BURBANK CA
91505-4325
US
IV. Provider business mailing address
3808 W RIVERSIDE DR #400
BURBANK CA
91505-4325
US
V. Phone/Fax
- Phone: 818-848-8840
- Fax: 818-848-0439
- Phone: 818-848-8840
- Fax: 818-848-0439
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A71225 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | A71225 |
| License Number State | CA |
VIII. Authorized Official
Name:
SCOTT
P.
SLIGH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-848-8840