Healthcare Provider Details

I. General information

NPI: 1992088926
Provider Name (Legal Business Name): SCOTT J MORIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SCOTT MORIN MD

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SPEAR ST STE 500
SAN FRANCISCO CA
94105-1537
US

IV. Provider business mailing address

610 FREEDOM BUSINESS CTR DR STE 310
KING OF PRUSSIA PA
19406-1329
US

V. Phone/Fax

Practice location:
  • Phone: 415-603-6999
  • Fax:
Mailing address:
  • Phone: 610-340-3530
  • Fax: 610-337-0185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA155267
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: