Individual
DR. SCOTT R. VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
513 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2205
(415) 502-7796
(415) 476-1963
Mailing address
1635 DIVISADERO STREET, SUITE 625, BOX 1821, SAN FRANCISCO, CA 94143-0001
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
G43859
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
G43859
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0G4385900
—
CA
Enumeration date
05/04/2006
Last updated
06/10/2008
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