Provider Demographics
NPI:1295877207
Name:SCOTT, FRANK EUGENE JR (DO)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:EUGENE
Last Name:SCOTT
Suffix:JR
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 W TEFFT ST STE 13
Mailing Address - Street 2:
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-8988
Mailing Address - Country:US
Mailing Address - Phone:805-473-4001
Mailing Address - Fax:805-477-3925
Practice Address - Street 1:671 W TEFFT ST STE 13
Practice Address - Street 2:
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444-8988
Practice Address - Country:US
Practice Address - Phone:805-473-4001
Practice Address - Fax:805-477-3925
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7253207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE20704Medicare UPIN