Provider Demographics
NPI:1568540029
Name:SCOTT, ELIZABETH ZIMMERMAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ZIMMERMAN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 EUCLID AVE
Mailing Address - Street 2:SUITE # 409
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2957
Mailing Address - Country:US
Mailing Address - Phone:619-267-8313
Mailing Address - Fax:619-472-2008
Practice Address - Street 1:655 EUCLID AVE
Practice Address - Street 2:SUITE # 409
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2957
Practice Address - Country:US
Practice Address - Phone:619-267-8313
Practice Address - Fax:619-472-2008
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80019207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0064490Medicaid