Healthcare Provider Details

I. General information

NPI: 1689942443
Provider Name (Legal Business Name): SCOTT R. HUNTER MD, MHS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14659 OLIVE VIEW DR
SYLMAR CA
91342-1652
US

IV. Provider business mailing address

1223 WILSHIRE BLVD # 873
SANTA MONICA CA
90403-5406
US

V. Phone/Fax

Practice location:
  • Phone: 213-330-6853
  • Fax:
Mailing address:
  • Phone: 424-272-0891
  • Fax: 888-971-3714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA123174
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA123174
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberA123174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: