Eric Jackson-Scott MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A115195 Issued in CA

Legal business name

ERIC JACKSON-SCOTT MD INC

Doing business as

EJS Medical Group

Practice address

455 N Prairie Ave
Inglewood, CA 90301-1413

Phone

(310) 412-0183

NPI assigned

Jan 10, 2012

Last updated

Jan 10, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eric Jackson-Scott, MDNPI 1467630806

Title

Medical Director

Phone

(310) 948-0485

Specialties & licenses 1

Addresses

Other names 1

• EJS Medical Group Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric D. Jackson-Scott, M.D.

  • Occupational Medicine Physician
  • Santa Cruz, CA
  • NPI 1467630806
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1538439302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 WESTWOOD BLVD STE 609",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642109",
            "telephone_number": "310-948-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 N PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011413",
            "telephone_number": "310-412-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC JACKSON-SCOTT MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "JACKSON-SCOTT",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-948-0485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A115195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EJS Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.