Healthcare Provider Details

I. General information

NPI: 1538309745
Provider Name (Legal Business Name): DAVID J SHEFFNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2009
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SUPERIOR AVE STE 330
NEWPORT BEACH CA
92663-2772
US

IV. Provider business mailing address

320 SUPERIOR AVE STE 330
NEWPORT BEACH CA
92663-2772
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-4323
  • Fax: 949-645-6650
Mailing address:
  • Phone: 949-645-4323
  • Fax: 949-645-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberA23419
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: