Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | G51289 | CA |
NPI | 1033122833 |
---|---|
Provider Name | Dr. Scott A Riedler |
First Address | San Diego, CA 92121-6310 |
Second Address | San Diego, CA 92121-6310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 27/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G512890 | (05) | CA |
A51958 | (02) | CA |