Provider Demographics
NPI:1780705327
Name:SCOTT, GREGORY EDWARD (HEARING AID DISPENSE)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:EDWARD
Last Name:SCOTT
Suffix:
Gender:M
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 PILLSBURY RD STE 194
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1373
Mailing Address - Country:US
Mailing Address - Phone:530-343-2350
Mailing Address - Fax:530-343-2505
Practice Address - Street 1:20 HILLTOP DR STE B
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-2856
Practice Address - Country:US
Practice Address - Phone:530-223-4567
Practice Address - Fax:530-223-4566
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3126237700000X
237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1013239037Medicaid