Provider Demographics
NPI:1245009299
Name:MACKAY, SCOTT (ATC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:MACKAY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20501 EARL ST STE 3
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-3048
Mailing Address - Country:US
Mailing Address - Phone:909-921-9255
Mailing Address - Fax:
Practice Address - Street 1:1950 E 16TH ST APT L220
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-5912
Practice Address - Country:US
Practice Address - Phone:909-921-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer