Provider Demographics
NPI:1174665020
Name:SCANDLING, JOHN D JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:SCANDLING
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:750 WELCH ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1509
Mailing Address - Country:US
Mailing Address - Phone:650-723-7929
Mailing Address - Fax:650-723-3997
Practice Address - Street 1:750 WELCH ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1509
Practice Address - Country:US
Practice Address - Phone:650-723-7929
Practice Address - Fax:650-723-3997
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2019-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG66051207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G660510Medicaid
NV18709OtherNV MD LICENSE
CAD01692Medicare UPIN