Provider Demographics
NPI:1780659276
Name:WENGER, SCOTT JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JAMES
Last Name:WENGER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:5893 COPLEY DR
Mailing Address - Street 2:4TH FLOOR GENERAL SURGERY DEPARTMENT
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-7906
Mailing Address - Country:US
Mailing Address - Phone:858-616-5011
Mailing Address - Fax:858-616-5040
Practice Address - Street 1:5893 COPLEY DR
Practice Address - Street 2:4TH FLOOR GENERAL SURGERY DEPARTMENT
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-7906
Practice Address - Country:US
Practice Address - Phone:858-616-5011
Practice Address - Fax:858-616-5040
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2021-11-18
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Provider Licenses
StateLicense IDTaxonomies
CA20A10859208600000X
OH34010762208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery