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JERALD R STAFFORD MD INC NPI 1366480790


NPI Information

NPI: 1366480790
Provider Name: JERALD R STAFFORD MD INC
Classification: Internal Medicine - 207RC0200X
Entity Type: Organization

Specialization: Critical Care Medicine

Address:
24411 HEALTH CENTER DR
SUITE 560
LAGUNA HILLS, CA
ZIP 92653
Phone: (949) 458-1223
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JERALD R STAFFORD MD INC is a critical care medicine internal medicine in Laguna Hills, CA. The provider is an internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. JERALD R STAFFORD MD INC NPI is 1366480790. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

24411 HEALTH CENTER DR
SUITE 560
LAGUNA HILLS, CA
ZIP 92653
Phone: (949) 458-1223
Fax: (949) 588-7572

The provider's authorized official is Jerald Robert Stafford .
The authorized official title is President and has the following contact phone number (949) 458-1223.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 10/12/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RP1001XInternal MedicinePulmonary DiseaseA25139CALIFORNIANo
2207RC0200XInternal MedicineCritical Care MedicineA25139CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100A251390MEDICAIDCALIFORNIA
2A24298MEDICARE UPIN
3W21073OTHERCALIFORNIAMEDICARE GROUP PTAN
4A25139MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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