MEDICARE: ROSALYN P SCOTT 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	G51920	CA

General Provider Information

NPI Number	:	1447305982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSALYN P SCOTT MD

Provider Business Mailing Address
First Line	:	4265 MARINA CITY DR UNIT 901
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-5809
Country	:	US
Telephone Number	:	310-493-6979
Fax Number	:	310-827-8821

Provider Business Practice Location Address
First Line	:	6109 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-3946
Country	:	US
Telephone Number	:	310-493-6979
Fax Number	:	310-827-8821

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	07/08/2007

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