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NPI Code Detail

MEDICARE: JENNIFER SCOTT MD

MEDICARE: JENNIFER 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
1207P00000XEmergency Medicine PhysicianA67309CA

General Provider Information

NPI Number : 1548295272
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER SCOTT MD
Provider Business Mailing Address
First Line : P.O. BOX 18223
Second Line :
City : SOUTH LAKE TAHOE
State : CA
Zip : 96151
Country : US
Telephone Number : 530-544-1875
Fax Number :
Provider Business Practice Location Address
First Line : 1065 BUCKS LAKE RD
Second Line :
City : QUINCY
State : CA
Zip : 95971-9599
Country : US
Telephone Number : 925-225-5837
Fax Number : 925-225-5838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 08/05/2020

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