Provider Demographics
NPI:1124023999
Name:WRIGHT-SCOTT, SHEILA L (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:L
Last Name:WRIGHT-SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W AVENUE Q
Mailing Address - Street 2:STE 1B
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3887
Mailing Address - Country:US
Mailing Address - Phone:661-948-4643
Mailing Address - Fax:661-948-1100
Practice Address - Street 1:615 W AVENUE Q
Practice Address - Street 2:STE 1B
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3887
Practice Address - Country:US
Practice Address - Phone:661-948-4643
Practice Address - Fax:661-948-1100
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2014-04-01
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
CAG45401174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G454012Medicaid
CA00G454012Medicaid
CAG45401AMedicare ID - Type Unspecified