Basic Information
| Provider Information | |||||||||
| NPI: | 1912061805 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRITZLAFF | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 BROADWAY ST | ||||||||
| Address2: | PAVILION A 1ST FLOOR MC 5340 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940633132 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 450 BROADWAY ST | ||||||||
| Address2: | PAVILION A 1ST FLOOR MC 5340 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940633132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236238 | ||||||||
| FaxNumber: | 6503209443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2006 | ||||||||
| LastUpdateDate: | 08/18/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 130974 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 130974 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.