Provider Demographics
NPI:1609839273
Name:KANE, HENRY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:SCOTT
Last Name:KANE
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 1:780 BAY BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5261
Mailing Address - Country:US
Mailing Address - Phone:619-842-2442
Mailing Address - Fax:
Practice Address - Street 1:780 BAY BLVD STE 203
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5261
Practice Address - Country:US
Practice Address - Phone:619-842-2442
Practice Address - Fax:619-842-2443
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC17114812084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry