Doctor Name: | SCOTT A STEPHAN |
NPI Number: | 1689905853 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | PA20679 |
Business Practice Address: | 24331 El Toro Rd Suite 200 Laguna Woods, CA - 926372752 |
Business Phone Number: | 9495863200 |
Business Fax Number: | 9499002136 |
Mailing Address: | Po Box 31063, LAGUNA HILLS |
State: | CA |
Postal Code: | 926541063 |
Phone Number: | 9495863200 |
Fax Number: | 9499002136 |
NPI Enumeration Date: | 01/27/2010 |
NPI Last Update Date: | 01/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA20679 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |