Provider Demographics
NPI:1457330953
Name:LAWRY, SCOTT PAUL (RPH)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:PAUL
Last Name:LAWRY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 HAGLAR WAY
Mailing Address - Street 2:UNIT #5
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-4666
Mailing Address - Country:US
Mailing Address - Phone:619-591-9789
Mailing Address - Fax:619-767-6607
Practice Address - Street 1:4170 NORMAN SCOTT RD
Practice Address - Street 2:BLDG 3232
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92136-5501
Practice Address - Country:US
Practice Address - Phone:619-767-6584
Practice Address - Fax:619-767-6607
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-036684-L183500000X
CARPH-44249183500000X
HIPH-1906183500000X
VA0202205633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist