Provider Demographics
NPI:1417315425
Name:E SCOTT SILLS, MD PHD
Entity Type:Organization
Organization Name:E SCOTT SILLS, MD PHD
Other - Org Name:CENTER FOR ADVANCED GENETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:E
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:760-994-0156
Mailing Address - Street 1:3144 EL CAMINO REAL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2194
Mailing Address - Country:US
Mailing Address - Phone:760-994-0156
Mailing Address - Fax:760-994-0159
Practice Address - Street 1:3144 EL CAMINO REAL
Practice Address - Street 2:SUITE 106
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2194
Practice Address - Country:US
Practice Address - Phone:760-994-0156
Practice Address - Fax:760-994-0159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty