Provider Demographics
NPI:1982794061
Name:LAYNE, SCOTT PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:PETER
Last Name:LAYNE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9310 SAWYER ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4102
Mailing Address - Country:US
Mailing Address - Phone:310-815-1285
Mailing Address - Fax:310-815-1286
Practice Address - Street 1:2121 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2303
Practice Address - Country:US
Practice Address - Phone:310-453-1324
Practice Address - Fax:424-212-5921
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-11-22
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Provider Licenses
StateLicense IDTaxonomies
CAG46596207RI0200X
NM83-71207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI28361Medicare UPIN