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General NPI Number Information
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NPI Number | 1003003187
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Entity Type | Organization
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Legal Business Name | FREDERICK L.STAFFORD M.D., INC.
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 25431 CABOT RD STE 107
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5526
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Country | US
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Telephone | 562-427-1322
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Fax | 562-427-2255
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Provider Business Mailing Address
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Address Line | 25431 CABOT RD STE 107
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5526
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Country | US
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Telephone | 562-427-1322
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Fax | 562-427-2255
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Authorized Official
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Title or Position | ADMIN
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Name | GABRIELLE ELIZABETH SALUD
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Credential |
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Telephone | 562-427-1322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | G57932
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License Number State | CA
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