Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC24836 | CA |
NPI | 1669481891 |
---|---|
Provider Name | Dr. Scott J Vrzal |
First Address | Laguna Niguel, CA 92677-1233 |
Second Address | Laguna Niguel, CA 92677-1233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 03/08/2011 |