Organization
GEORGE C SCOTT MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE C SCOTT MD (OWNER)
(415) 302-2506
Entity
Organization
Contact information
Practice address
1191 E YOSEMITE AVE, STE C, MANTECA, CA 95336-5011
(209) 239-4100
(209) 239-4110
Mailing address
1191 E YOSEMITE AVE, STE C, MANTECA, CA 95336-5011
(209) 239-4100
(209) 239-4110
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G55402
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G554020
—
CA
05
—
2176339
—
CA
Enumeration date
04/11/2010
Last updated
09/03/2010
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