MEDICARE: DR. SCOTT DOUGLAS GREER M.D.

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	174400000X	Specialist	G45633	CA

General Provider Information

NPI Number	:	1811993561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT DOUGLAS GREER M.D.

Provider Business Mailing Address
First Line	:	6280 JACKSON DR
Second Line	:	STE 8
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-3436
Country	:	US
Telephone Number	:	619-464-1608
Fax Number	:	619-461-8738

Provider Business Practice Location Address
First Line	:	6280 JACKSON DR
Second Line	:	STE 8
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-3436
Country	:	US
Telephone Number	:	619-464-1608
Fax Number	:	619-461-8738

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	07/08/2007

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