Healthcare Provider Details

I. General information

NPI: 1710624002
Provider Name (Legal Business Name): ADRIAN DONOVAN SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1282 MARKET ST
SAN FRANCISCO CA
94102-4801
US

IV. Provider business mailing address

1282 MARKET ST
SAN FRANCISCO CA
94102-4801
US

V. Phone/Fax

Practice location:
  • Phone: 415-579-3021
  • Fax: 415-795-3330
Mailing address:
  • Phone: 415-579-2021
  • Fax: 415-795-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: