Healthcare Provider Details

I. General information

NPI: 1447223326
Provider Name (Legal Business Name): SCOTT EDWARD MUSINSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 W CANYON AVE
SAN DIEGO CA
92123-5428
US

IV. Provider business mailing address

3160 W CANYON AVE
SAN DIEGO CA
92123-5428
US

V. Phone/Fax

Practice location:
  • Phone: 760-583-0924
  • Fax:
Mailing address:
  • Phone: 760-583-0924
  • Fax: 844-352-6658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG85560
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG85560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: