Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A132166 | CA |
Y | 2080P0204X | Pediatric Emergency Doctor | MD61071894 | WA |
NPI | 1144617291 |
---|---|
Provider Name | Dr. Scott Michael Sutton |
First Address | San Francisco, CA 94143-2351 |
Second Address | San Diego, CA 92123-4223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 25/09/2020 |