Scott Robertson MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SCOTT ROBERTSON MD INC

Practice address

901 Oak Park Blvd
Suite 100
Pismo Beach, CA 93449-3408

Phone

(805) 489-2205

Fax

(805) 489-2206

NPI assigned

Oct 19, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Scott E Robertson, MD

Title

President

Phone

(805) 489-2205

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1598091068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934480009",
            "telephone_number": "805-489-2205",
            "fax_number": "805-489-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD",
            "address_2": "SUITE 100",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493408",
            "telephone_number": "805-489-2205",
            "fax_number": "805-489-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT ROBERTSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-19",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-489-2205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPH CLINICAL LABORATORY REGISTRATION NUMBER",
            "identifier": "CLP00339667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DEPT OF CORPORATIONS NUMBER",
            "identifier": "C3228143",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "05D2006808",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana Leigh Schiro
• Marilyn Mullaney Schmidt, LMFT
• Mary Ann Schneider, PA-C
• Wallace Jack Schwam, M.D.
• Scott E Schachter Oda Professional Corporation
• Alexandria Settevendemie, PT, DPT
• Young Hoon Shin, PHARM,D
• Sierra Neuromonitoring LLC
• Nicole Lynn Simental, RN- BSN FNP
• James Robert Skow, M.D., F.A.C.S.

• Family Medicine Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.