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Individual
SCOTT ALAN ENGWALL
Active
Individual
SCOTT ALAN ENGWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G64211
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G642110
BLUE SHIELD
—
05
—
00G642110
—
CA
Enumeration date
12/27/2005
Last updated
02/14/2008
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