Provider Demographics
NPI:1275563058
Name:NARIMATSU, SCOTT K (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:K
Last Name:NARIMATSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13044 PACIFIC PROMENADE APT 109
Mailing Address - Street 2:
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-4005
Mailing Address - Country:US
Mailing Address - Phone:310-922-7601
Mailing Address - Fax:
Practice Address - Street 1:15107 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4542
Practice Address - Country:US
Practice Address - Phone:818-782-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88839207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A888390Medicaid
CA00A888392Medicare PIN
CAI30299Medicare UPIN
CAWA88839GMedicare PIN
CAWA88839KMedicare PIN
CAWA88839JMedicare PIN
CA00A888393Medicare PIN
CAWA88839IMedicare PIN
CA00A888390Medicaid
CA00A888394Medicare PIN