MEDICARE: DR. DELANEY J SCOLLAN 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	207V00000X	Obstetrics & Gynecology Physician	036175483	IL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1801475843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DELANEY J SCOLLAN MD

Provider Business Mailing Address
First Line	:	10833 LE CONTE AVE # CHS27139
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-3075
Country	:	US
Telephone Number	:	310-825-9945
Fax Number	:

Provider Business Practice Location Address
First Line	:	10833 LE CONTE AVE # CHS27139
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-3075
Country	:	US
Telephone Number	:	310-825-9945
Fax Number	:

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

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	02/16/2026

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