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General NPI Number Information
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NPI Number | 1699013318
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Entity Type | Individual
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Provider Name | SAMUELLA OLAYINKA SCOTT PA-C, MSHS, MPH
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Gender | Female
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 333 1ST ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-2687
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Country | US
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Telephone | 888-803-3370
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Fax | 888-803-3331
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Provider Business Mailing Address
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Address Line | 6406 57TH AVE
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City | RIVERDALE
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State | MD
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Zip | 20737-2819
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Country | US
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Telephone | 301-704-9370
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C04960
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 56872
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License Number State | CA
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