Healthcare Provider Details

I. General information

NPI: 1427042050
Provider Name (Legal Business Name): SCOTT BRAUNSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

PO BOX 51258
LOS ANGELES CA
90051-5558
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-8600
  • Fax: 310-967-1800
Mailing address:
  • Phone: 310-423-8600
  • Fax: 310-967-1800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA76114
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberA76114
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA76114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: