Provider Demographics
NPI:1528282563
Name:WHITMORE, SCOTT ANTHONY (DPM)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANTHONY
Last Name:WHITMORE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-3529
Mailing Address - Country:US
Mailing Address - Phone:562-429-4363
Mailing Address - Fax:
Practice Address - Street 1:5445 DEL AMO BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2761
Practice Address - Country:US
Practice Address - Phone:562-867-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4592213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE4592Medicare ID - Type Unspecified
V02561Medicare UPIN