Provider Demographics
NPI:1912061805
Name:PRITZLAFF, SCOTT G (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:G
Last Name:PRITZLAFF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:450 BROADWAY ST
Mailing Address - Street 2:PAVILION A 1ST FLOOR MC 5340
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-3132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 BROADWAY ST
Practice Address - Street 2:PAVILION A 1ST FLOOR MC 5340
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-3132
Practice Address - Country:US
Practice Address - Phone:650-723-6238
Practice Address - Fax:650-320-9443
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2015-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA130974207L00000X, 207LP2900X, 207LP2900X, 207L00000X
MA247637207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine