Individual
DR. SCOTT A DERKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16200 SAND CANYON AVE, IRVINE, CA 92618-3714
(949) 610-7245
(657) 241-7720
Mailing address
PO BOX 3589, NEWPORT BEACH, CA 92659-8589
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C54344
CA
207R00000X
Internal Medicine Physician
ME74898
FL
208M00000X
Hospitalist Physician
Primary
C54344
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254121100
—
FL
01
—
P00939089
MEDICARE RAILROAD
CA
Enumeration date
06/22/2005
Last updated
05/30/2017
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