Provider Demographics
NPI:1649473323
Name:SCOTT, EMILIE KATHRYN (MD)
Entity type:Individual
Prefix:DR
First Name:EMILIE
Middle Name:KATHRYN
Last Name:SCOTT
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Gender:F
Credentials:MD
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Mailing Address - Street 1:19742 MACARTHUR BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2488
Mailing Address - Country:US
Mailing Address - Phone:949-453-4308
Mailing Address - Fax:949-453-4328
Practice Address - Street 1:15785 LAGUNA CANYON RD
Practice Address - Street 2:SUITE 310
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3165
Practice Address - Country:US
Practice Address - Phone:949-453-4308
Practice Address - Fax:949-453-4328
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2016-04-11
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Provider Licenses
StateLicense IDTaxonomies
NY244534207Q00000X
CAA103490207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB209818Medicare PIN