Provider Demographics
NPI:1063385433
Name:PIPER, SCOTT MICHAEL
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:MICHAEL
Last Name:PIPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29143 BOTTLEBRUSH
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-9135
Mailing Address - Country:US
Mailing Address - Phone:714-403-3463
Mailing Address - Fax:
Practice Address - Street 1:40024 HARVESTON DR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4802
Practice Address - Country:US
Practice Address - Phone:714-403-3463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider