Provider Demographics
NPI:1316023906
Name:DE LA FE, SCOTT ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANTHONY
Last Name:DE LA FE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2469
Mailing Address - Country:US
Mailing Address - Phone:480-507-3380
Mailing Address - Fax:480-507-0656
Practice Address - Street 1:2401 E BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2469
Practice Address - Country:US
Practice Address - Phone:480-507-3380
Practice Address - Fax:480-507-0656
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25050111N00000X
AZ7492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0942130OtherBLUE CROSS BLUE SHIELD
AZ900171223OtherRAILROAD MEDICARE
AZ9071491OtherPHCS
AZ2Z1916OtherAHCCCS
AZAZ0942130OtherBLUE CROSS BLUE SHIELD
AZ85026Medicare PIN