# SCOTT SMALL, D.O., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083123400
- **Authorized official:** SCOTT SMALL MD (DIRECTOR)
- **Authorized official phone:** (516) 659-0544

## Contact information

- **Practice address:** 17251 17TH ST, TUSTIN, CA 92780-1970
- **Practice address phone:** (714) 832-2273
- **Practice address fax:** (714) 832-2272
- **Mailing address:** 8320 RESIDENCIA, NEWPORT BEACH, CA 92660-9063
- **Mailing address phone:** (516) 659-0544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 20A11607 | CA | Yes |

## Other

- **Enumeration date:** 09/28/2017
- **Last updated:** 09/28/2017