Basic Information
Provider Information
NPI: 1033116918
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOSTER
FirstName: SCOTT
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10470 OLD PLACERVILLE RD
Address2: #310
City: SACRAMENTO
State: CA
PostalCode: 958272539
CountryCode: US
TelephoneNumber: 8666810736
FaxNumber:  
Practice Location
Address1: 2801 L ST
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958165615
CountryCode: US
TelephoneNumber: 9167333061
FaxNumber: 9167338925
Other Information
ProviderEnumerationDate: 07/07/2005
LastUpdateDate: 06/01/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085B0100XG83889CAN Allopathic & Osteopathic PhysiciansRadiologyBody Imaging
2085N0700XG83889CAN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085N0904XG83889CAN Allopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
2085R0202XG83889CAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0203XG83889CAN Allopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
2085R0204XG83889CAN Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
2085R0205XG83889CAN Allopathic & Osteopathic PhysiciansRadiologyRadiological Physics
2085U0001XG83889CAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound

No ID Information.


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