Healthcare Provider Details

I. General information

NPI: 1265144067
Provider Name (Legal Business Name): ROBERT E SCOTT MD INC APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2022
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9834 GENESEE AVE STE 223B
LA JOLLA CA
92037-1215
US

IV. Provider business mailing address

9834 GENESEE AVE STE 223B
LA JOLLA CA
92037-1215
US

V. Phone/Fax

Practice location:
  • Phone: 858-277-7123
  • Fax:
Mailing address:
  • Phone: 858-277-7123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E SCOTT
Title or Position: OWNER
Credential: MD
Phone: 858-449-1662