Healthcare Provider Details

I. General information

NPI: 1043629280
Provider Name (Legal Business Name): SCOTT E. REDMOND, D.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2014
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST STE 206
PASADENA CA
91106-2401
US

IV. Provider business mailing address

960 E GREEN ST STE 206
PASADENA CA
91106-2401
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-8469
  • Fax: 626-449-7910
Mailing address:
  • Phone: 626-449-8469
  • Fax: 626-449-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number25372
License Number StateCA

VIII. Authorized Official

Name: DR. SCOTT EDWARD REDMOND
Title or Position: CHIROPRACTOR/QME
Credential: D.C.
Phone: 626-449-8469