MEDICARE: DAVID ERIC SCAFIDI MD

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	2085R0202X	Diagnostic Radiology Physician	G80079	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00G800790	OTHER	CA	BCBS

General Provider Information

NPI Number	:	1215903158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ERIC SCAFIDI MD

Provider Business Mailing Address
First Line	:	DEPT LA 21693
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91185-1693
Country	:	US
Telephone Number	:	858-564-1400
Fax Number	:	858-564-1500

Provider Business Practice Location Address
First Line	:	36320 INLAND VALLEY DR
Second Line	:	STE 101
City	:	WILDOMAR
State	:	CA
Zip	:	92595-7512
Country	:	US
Telephone Number	:	951-600-3811
Fax Number	:

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	05/15/2008

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