Organization
SCOTT SMALL, D.O., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT SMALL MD (DIRECTOR)
(516) 659-0544
Entity
Organization
Contact information
Practice address
17251 17TH ST, TUSTIN, CA 92780-1970
(714) 832-2273
(714) 832-2272
Mailing address
8320 RESIDENCIA, NEWPORT BEACH, CA 92660-9063
(516) 659-0544
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
20A11607
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A11607
MEDICAL LICENSE
CA
Enumeration date
09/28/2017
Last updated
09/28/2017
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