Individual
SCOTT LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10171 OBRIEN PL, SAN DIEGO, CA 92124-2922
(240) 422-5256
Mailing address
10171 OBRIEN PL, SAN DIEGO, CA 92124-2922
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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