Provider Demographics
NPI:1558474320
Name:SAUNDERS, SCOTT DAVID (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:DAVID
Last Name:SAUNDERS
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 1:606 ALAMO PINTADO RD STE 3-174
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2284
Mailing Address - Country:US
Mailing Address - Phone:805-688-7171
Mailing Address - Fax:805-963-1826
Practice Address - Street 1:5901 ENCINA RD STE C3
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2272
Practice Address - Country:US
Practice Address - Phone:805-963-1824
Practice Address - Fax:805-963-1826
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78847207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAET891AMedicare UPIN
CAG78847Medicare ID - Type Unspecified