Healthcare Provider Details

I. General information

NPI: 1558424143
Provider Name (Legal Business Name): SCOTT CUYJET NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 JUNIPERO SERRA BLVD
DALY CITY CA
94015-1634
US

IV. Provider business mailing address

2780 JUNIPERO SERRA BLVD
DALY CITY CA
94015-1634
US

V. Phone/Fax

Practice location:
  • Phone: 650-301-8600
  • Fax:
Mailing address:
  • Phone: 650-301-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number521003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: