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1396061776 NPI number — GEORGE C SCOTT MD

NPI Number: 1396061776
Health Care Provider/Practitioner: GEORGE C SCOTT MD

Information about “1396061776” NPI (GEORGE C SCOTT MD) exists in 1396061776 in HTML format HTML  |  1396061776 in plain Text format TXT  |  1396061776 in PDF (Portable Document Format) PDF  |  1396061776 in an XML format XML  formats.

NPI Number : 1396061776 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396061776",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GEORGE C SCOTT MD",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1191 E YOSEMITE AVE",
    "SecondLineMailingAddress": "STE C",
    "MailingAddressCityName": "MANTECA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95336-5011",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "209-239-4100",
    "MailingAddressFaxNumber": "209-239-4110",
    "FirstLinePracticeLocationAddress": "1191 E YOSEMITE AVE",
    "SecondLinePracticeLocationAddress": "STE C",
    "PracticeLocationAddressCityName": "MANTECA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95336-5011",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "209-239-4100",
    "PracticeLocationAddressFaxNumber": "209-239-4110",
    "EnumerationDate": "04/11/2010",
    "LastUpdateDate": "09/03/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SCOTT",
    "AuthorizedOfficialFirstName": "GEORGE",
    "AuthorizedOfficialMiddleName": "C",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "415-302-2506",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM2500X",
        "TaxonomyName": "Medical Specialty Clinic/Center",
        "LicenseNumber": "G55402",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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