Healthcare Provider Details

I. General information

NPI: 1104019348
Provider Name (Legal Business Name): SCOTT DAVID MEIER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10305 PROMENADE PKWY
ELK GROVE CA
95757-9400
US

IV. Provider business mailing address

10305 PROMENADE PARKWAY
ELK GROVE CA
95757-9400
US

V. Phone/Fax

Practice location:
  • Phone: 916-544-6688
  • Fax:
Mailing address:
  • Phone: 916-544-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA101884
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: