1699708206 NPI number — SCOTT P. SLIGH, M.D., A MEDICAL CORPORATION

Table of content: (NPI 1699708206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699708206 NPI number — SCOTT P. SLIGH, M.D., A MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCOTT P. SLIGH, M.D., A MEDICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699708206
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3808 W RIVERSIDE DR
Provider Second Line Business Mailing Address:
#400
Provider Business Mailing Address City Name:
BURBANK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91505-4325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-848-8840
Provider Business Mailing Address Fax Number:
818-848-0439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3808 W RIVERSIDE DR
Provider Second Line Business Practice Location Address:
#400
Provider Business Practice Location Address City Name:
BURBANK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91505-4325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-848-8840
Provider Business Practice Location Address Fax Number:
818-848-0439
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SLIGH
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
818-848-8840

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  A71225 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 208C00000X , with the licence number: A71225 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com