Provider Demographics
NPI:1194068494
Name:LANDERS, SCOTT ALAN (PHARMD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:LANDERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 S BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-8005
Mailing Address - Country:US
Mailing Address - Phone:805-922-3430
Mailing Address - Fax:805-322-9367
Practice Address - Street 1:1540 FROOM RANCH WAY
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-7211
Practice Address - Country:US
Practice Address - Phone:805-541-7028
Practice Address - Fax:805-541-7025
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562731835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist