Provider Demographics
NPI:1104869056
Name:SLIGH, SCOTT P (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:SLIGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 W RIVERSIDE DR
Mailing Address - Street 2:SUITE#400
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4325
Mailing Address - Country:US
Mailing Address - Phone:818-848-8840
Mailing Address - Fax:818-848-0439
Practice Address - Street 1:3808 W RIVERSIDE DR
Practice Address - Street 2:SUITE#400
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4325
Practice Address - Country:US
Practice Address - Phone:818-848-8840
Practice Address - Fax:818-848-0439
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71225208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A712250Medicaid
CA00A712250Medicaid