Healthcare Provider Details

I. General information

NPI: 1649473323
Provider Name (Legal Business Name): EMILIE KATHRYN SCOTT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15785 LAGUNA CANYON RD SUITE 310
IRVINE CA
92618-3165
US

IV. Provider business mailing address

19742 MACARTHUR BLVD STE 250
IRVINE CA
92612-2488
US

V. Phone/Fax

Practice location:
  • Phone: 949-453-4308
  • Fax: 949-453-4328
Mailing address:
  • Phone: 949-453-4308
  • Fax: 949-453-4328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number244534
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA103490
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: