Provider Demographics
NPI:1801378070
Name:ELDON, WILLIAM SCOTT (DPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SCOTT
Last Name:ELDON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 OCEAN RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-2669
Mailing Address - Country:US
Mailing Address - Phone:760-696-3376
Mailing Address - Fax:877-559-5308
Practice Address - Street 1:3600 OCEAN RANCH BLVD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-2669
Practice Address - Country:US
Practice Address - Phone:760-696-3376
Practice Address - Fax:877-559-5308
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
CA295610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist