Provider Demographics
NPI:1700832433
Name:SCOLINOS, FRANK (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:SCOLINOS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1217
Mailing Address - Country:US
Mailing Address - Phone:310-671-2020
Mailing Address - Fax:
Practice Address - Street 1:236 N MARKET ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1217
Practice Address - Country:US
Practice Address - Phone:310-671-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9568T152W00000X
CA9568TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGSD001681Medicaid
CAGSD001681Medicaid