Provider Demographics
NPI:1053468975
Name:HARDY, SCOTT (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:HARDY
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16552 GRAHAM PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-3619
Mailing Address - Country:US
Mailing Address - Phone:714-846-6650
Mailing Address - Fax:
Practice Address - Street 1:2703 N BRISTOL ST
Practice Address - Street 2:SUITE H-2
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-1472
Practice Address - Country:US
Practice Address - Phone:714-648-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG059180207PT0002X, 2083P0500X, 2083T0002X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Not Answered2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Not Answered2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine