Provider Demographics
NPI:1700014438
Name:SCOTT, MICHAEL ARTHUR (BS, DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:SCOTT
Suffix:
Gender:M
Credentials:BS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10739 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2219
Mailing Address - Country:US
Mailing Address - Phone:424-260-5778
Mailing Address - Fax:310-775-4342
Practice Address - Street 1:10739 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2219
Practice Address - Country:US
Practice Address - Phone:424-260-5778
Practice Address - Fax:310-775-4342
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist