Jerald R Stafford Md Inc
LBN: Jerald R Stafford Md Inc
Jerald R Stafford Md Inc is an health care organization with primary practice located at 24411 Health Center Dr Suite 560, Laguna Hills CA 92653. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is the primary health care specialty.
Jerald R Stafford Md Inc can be contacted via phone (949) 458-1223, or through Stafford, Jerald Robert via phone (949) 458-1223.
Contact Information
Primary practice address
24411 Health Center Dr Suite 560
Laguna Hills CA 92653
Phone: (949) 458-1223
Fax: (949) 588-7572
Website:
Authorized official contact:
Name: Stafford, Jerald Robert Doctor of Medicine (MD)
Phone: (949) 458-1223
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | A25139 | California |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | A25139 | California |
Profile Details
| NPI number | 1366480790 |
|---|---|
| LBN Legal business name | Jerald R Stafford Md Inc |
| DBA Doing business as | |
| Authorized official | Stafford, Jerald Robert Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 4th, 2006 |
| Last updated | Oct 12th, 2007 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366480790 | NPPES |
| California | Other | W21073 | MEDICARE GROUP PTAN |
| California | MEDICAID | 00A251390 | MEDICARE GROUP PTAN |
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