Healthcare Provider Details

I. General information

NPI: 1053468975
Provider Name (Legal Business Name): SCOTT HARDY M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 N BRISTOL ST SUITE H-2
SANTA ANA CA
92706-1472
US

IV. Provider business mailing address

16552 GRAHAM PL
HUNTINGTON BEACH CA
92649-3619
US

V. Phone/Fax

Practice location:
  • Phone: 714-648-0335
  • Fax:
Mailing address:
  • Phone: 714-846-6650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License NumberG059180
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberG059180
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License NumberG059180
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberG059180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: