Provider Demographics
NPI:1053036897
Name:GEILER, SCOTT D (PA-C)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:GEILER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W SEASIDE WAY APT 3218
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-7910
Mailing Address - Country:US
Mailing Address - Phone:201-396-9244
Mailing Address - Fax:
Practice Address - Street 1:250 W SEASIDE WAY APT 3218
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-7910
Practice Address - Country:US
Practice Address - Phone:201-396-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA61739207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine