Healthcare Provider Details

I. General information

NPI: 1972569838
Provider Name (Legal Business Name): SCOTT WALTER PUZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 12/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 WHIPPLE RD
UNION CITY CA
94587-1507
US

IV. Provider business mailing address

3553 WHIPPLE RD
UNION CITY CA
94587-1507
US

V. Phone/Fax

Practice location:
  • Phone: 510-454-1000
  • Fax:
Mailing address:
  • Phone: 510-454-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberG84336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: