Individual
DR. SCOTT MICHAEL DE WENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
600 CENTRAL AVE, STE G, LAKE ELSINORE, CA 92530-2740
(951) 245-7472
(951) 674-1156
Mailing address
600 CENTRAL AVE, STE G, LAKE ELSINORE, CA 92530-2740
(951) 245-7472
(951) 674-1156
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E40800
—
CA
Enumeration date
07/14/2006
Last updated
07/08/2007
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