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General NPI Number Information
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NPI Number | 1205991973
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Entity Type | Individual
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Provider Name | SCOTT DAVID BRICKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/23/2006
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Last Update Date | 10/07/2016
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Provider Practice Location Address
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Address Line | 15031 RINALDI ST
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City | MISSION HILLS
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State | CA
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Zip | 91345-1207
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Country | US
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Telephone | 310-941-5059
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Fax |
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Provider Business Mailing Address
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Address Line | 1856 ELMFIELD AVE
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City | LONG BEACH
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State | CA
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Zip | 90815-3034
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Country | US
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Telephone | 310-941-5059
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A90638
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License Number State | CA
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