| James T Scott Md A Professional Corporation | |
|
12011 San Vicente Blvd 408 Los Angeles CA 90049-4926 | |
| (310) 883-8153 | |
| (310) 454-7351 |
| Full Name | James T Scott Md A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 12011 San Vicente Blvd, Los Angeles, California |
| Authorized Official Name and Position | James Thomas Scott (PRESIDENT) |
| Authorized Official Contact | 3108838153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James T Scott Md A Professional Corporation 12011 San Vicente Blvd 408 Los Angeles CA 90049-4926 Ph: (310) 883-8153 | James T Scott Md A Professional Corporation 12011 San Vicente Blvd 408 Los Angeles CA 90049-4926 Ph: (310) 883-8153 |
| NPI Number | 1043544505 |
|---|---|
| Provider Enumeration Date | 09/30/2009 |
| Last Update Date | 07/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043544505 | NPI | - | NPPES |
| 00G217320 | Medicaid | CA | |
| DE555A | Other | CA | MEDICARE GROUP PTAN |
| 1770667578 | Other | CA | INDIVIDUAL NPI |
| DE556Z | Other | CA | MEDICARE INDIVIDUAL PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G21732 (California) | Primary |
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