Healthcare Provider Details
I. General information
NPI: 1619246931
Provider Name (Legal Business Name): SCALES MEDICAL SERVICES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2011
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3579 E FOOTHILL BLVD SUITE 188
PASADENA CA
91107-3119
US
IV. Provider business mailing address
3579 E FOOTHILL BLVD SUITE 188
PASADENA CA
91107-3119
US
V. Phone/Fax
- Phone: 714-267-6137
- Fax:
- Phone: 714-267-6137
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | G58330 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
EDDIE
JAY
SCALES
Title or Position: OWNER
Credential: M.D
Phone: 951-695-9648