Provider Demographics
NPI:1558674523
Name:AHL, SCOTT GERALD (DO)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:GERALD
Last Name:AHL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19582 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5994
Mailing Address - Country:US
Mailing Address - Phone:714-477-8020
Mailing Address - Fax:
Practice Address - Street 1:19582 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5994
Practice Address - Country:US
Practice Address - Phone:714-477-8020
Practice Address - Fax:714-477-8022
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A-12063207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism