MEDICARE: SCOTT DINSMOOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1003034299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT DINSMOOR

Provider Business Mailing Address
First Line	:	8285 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5956
Country	:	US
Telephone Number	:	323-377-9142
Fax Number	:

Provider Business Practice Location Address
First Line	:	8285 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5956
Country	:	US
Telephone Number	:	323-377-9142
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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Directions to “ SCOTT DINSMOOR ” Practice Location

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