Basic Information
| Provider Information | |||||||||
| NPI: | 1205042470 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAISER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 20TH ST | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108284411 | ||||||||
| FaxNumber: | 3108282411 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 20TH ST STE 150 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105827450 | ||||||||
| FaxNumber: | 3105827495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 04/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 225913 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A120608 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QG0300X | 235987 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 207QG0300X | A120608 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
No ID Information.