Provider Demographics
NPI:1689762221
Name:SCOTT ROME MD INC
Entity Type:Organization
Organization Name:SCOTT ROME MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:R
Authorized Official - Last Name:COMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-686-1145
Mailing Address - Street 1:PO BOX 7759
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-1046
Mailing Address - Country:US
Mailing Address - Phone:415-600-7710
Mailing Address - Fax:415-600-7715
Practice Address - Street 1:45 CASTRO ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1010
Practice Address - Country:US
Practice Address - Phone:415-600-7710
Practice Address - Fax:415-600-7715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ18642ZMedicare PIN