Provider Demographics
NPI:1871699801
Name:SOIFER, SCOTT J (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:J
Last Name:SOIFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:478 LIVE OAK DR
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3975
Mailing Address - Country:US
Mailing Address - Phone:415-381-5364
Mailing Address - Fax:415-502-4186
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:MOFFITT 680, BOX 0106
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-476-5153
Practice Address - Fax:415-502-4186
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2012-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG404052080P0202X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G404050Medicare ID - Type Unspecified
CAA48212Medicare UPIN