Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | G69621 | CA |
NPI | 1003910456 |
---|---|
Provider Name | Emily Dyson Scott |
First Address | San Diego, CA 92103-2120 |
Second Address | San Diego, CA 92103-2120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 15/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G696212 | (05) | CA |
F19731 | (02) |