Basic Information
Provider Information
NPI: 1912957267
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCOTT
FirstName: ALAN
MiddleName: LODER
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1450 TREAT BLVD STE 300
Address2:  
City: WALNUT CREEK
State: CA
PostalCode: 945972168
CountryCode: US
TelephoneNumber: 9259522828
FaxNumber:  
Practice Location
Address1: 1450 TREAT BLVD STE 160
Address2:  
City: WALNUT CREEK
State: CA
PostalCode: 945972168
CountryCode: US
TelephoneNumber: 9252969000
FaxNumber: 9252969071
Other Information
ProviderEnumerationDate: 05/10/2006
LastUpdateDate: 08/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XC161181CAY Allopathic & Osteopathic PhysiciansFamily Medicine 
207P00000XC161181CAN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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