Healthcare Provider Details

I. General information

NPI: 1295990711
Provider Name (Legal Business Name): AMY MAO SCALA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY MAO M.D.

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 02/11/2022
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 LAWRENCE EXPY DEPT 186
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

1800 HARRISON ST 7TH FL
OAKLAND CA
94612-3429
US

V. Phone/Fax

Practice location:
  • Phone: 408-554-9810
  • Fax:
Mailing address:
  • Phone: 408-851-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number261032
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA102229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: