Healthcare Provider Details

I. General information

NPI: 1013917038
Provider Name (Legal Business Name): WAYNE SCOTT INMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

H100 SANTA MARGARITA ROAD NAVAL HOSPITAL
CAMP PENDLETON CA
92055-5191
US

IV. Provider business mailing address

5031 AVENIDA DE LA PLATA
OCEANSIDE CA
92057-8019
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1317
  • Fax:
Mailing address:
  • Phone: 760-631-8337
  • Fax: 760-295-7754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG63385
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: