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General NPI Number Information
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NPI Number | 1285696278
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Entity Type | Individual
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Provider Name | SCOTT R NELSON D.O., FACEP
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 24361 EL TORO RD SUITE 120
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-2755
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Country | US
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Telephone | 949-916-6321
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Fax | 949-916-6340
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Provider Business Mailing Address
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Address Line | 24361 EL TORO RD SUITE 120
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-2755
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Country | US
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Telephone | 949-916-6321
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Fax | 949-916-6340
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | G3643
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | G3643
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | G3643
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License Number State | TX
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