| Scott Robertson Md Inc | |
|
901 Oak Park Blvd Suite 100 Pismo Beach CA 93449-3408 | |
| (805) 489-2205 | |
| (805) 489-2206 |
| Full Name | Scott Robertson Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 901 Oak Park Blvd, Pismo Beach, California |
| Authorized Official Name and Position | Scott E Robertson (PRESIDENT) |
| Authorized Official Contact | 8054892205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Robertson Md Inc Po Box 9 Pismo Beach CA 93448-0009 Ph: (805) 489-2205 | Scott Robertson Md Inc 901 Oak Park Blvd Suite 100 Pismo Beach CA 93449-3408 Ph: (805) 489-2205 |
| NPI Number | 1598091068 |
|---|---|
| Provider Enumeration Date | 10/19/2009 |
| Last Update Date | 12/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598091068 | NPI | - | NPPES |
| CLP00339667 | Other | CA | DPH CLINICAL LABORATORY REGISTRATION NUMBER |
| C3228143 | Other | CA | CA DEPT OF CORPORATIONS NUMBER |
| 05D2006808 | Other | CA | CLIA WAIVER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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