Healthcare Provider Details

I. General information

NPI: 1528009594
Provider Name (Legal Business Name): WILLIAM SCOTT JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N ROSE AVE
OXNARD CA
93030-3722
US

IV. Provider business mailing address

305 DURLEY AVE
CAMARILLO CA
93010-9119
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-2843
  • Fax: 805-988-2844
Mailing address:
  • Phone: 805-987-0516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number20A4200
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A4200
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number20A4200
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: