Provider Demographics
NPI:1609933852
Name:TANNEHILL, SCOTT ALAN
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:TANNEHILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10811 WASHINGTON BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3670
Mailing Address - Country:US
Mailing Address - Phone:310-475-9111
Mailing Address - Fax:310-943-1752
Practice Address - Street 1:10811 WASHINGTON BLVD STE 250
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3670
Practice Address - Country:US
Practice Address - Phone:310-475-9111
Practice Address - Fax:310-943-1752
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor