Provider Demographics
NPI:1043629280
Name:SCOTT E. REDMOND, D.C
Entity type:Organization
Organization Name:SCOTT E. REDMOND, D.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/QME
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-449-8469
Mailing Address - Street 1:960 E GREEN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2401
Mailing Address - Country:US
Mailing Address - Phone:626-449-8469
Mailing Address - Fax:626-449-7910
Practice Address - Street 1:960 E GREEN ST STE 206
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-449-8469
Practice Address - Fax:626-449-7910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25372111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty