Provider Demographics
NPI:1295721686
Name:KANTOR, SCOTT GORDON (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:GORDON
Last Name:KANTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:SCOTT
Other - Middle Name:GORDON
Other - Last Name:KANTOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:576 HARTNELL ST
Mailing Address - Street 2:STE 200
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2834
Mailing Address - Country:US
Mailing Address - Phone:831-626-8988
Mailing Address - Fax:
Practice Address - Street 1:576 HARTNELL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2833
Practice Address - Country:US
Practice Address - Phone:831-375-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG080215174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist