Provider Demographics
NPI:1013618503
Name:SOUTHERN HEALTH NP GROUP
Entity type:Organization
Organization Name:SOUTHERN HEALTH NP GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:925-808-0305
Mailing Address - Street 1:149 LOVERIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5360
Mailing Address - Country:US
Mailing Address - Phone:925-808-0305
Mailing Address - Fax:
Practice Address - Street 1:149 LOVERIDGE CIR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5360
Practice Address - Country:US
Practice Address - Phone:925-808-0305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN HEALTH NP GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health