Provider Demographics
NPI:1386669455
Name:SCOTT, NEAL ANTHONY (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ANTHONY
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 HOSPITAL DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4122
Mailing Address - Country:US
Mailing Address - Phone:650-961-7021
Mailing Address - Fax:960-969-8679
Practice Address - Street 1:2490 HOSPITAL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4122
Practice Address - Country:US
Practice Address - Phone:650-962-4460
Practice Address - Fax:960-962-4457
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52828207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G528280OtherBLUE SHIELD PROVIDER ID
CA00G528280OtherBLUE SHIELD PROVIDER ID
CAA89951Medicare UPIN