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General NPI Number Information
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NPI Number | 1114924420
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Entity Type | Individual
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Provider Name | MONIQUE LOUISE KNOPF-SHAFFER PA
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 47 OBERY ST
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City | PLYMOUTH
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State | MA
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Zip | 02360-2229
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Country | US
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Telephone | 508-747-1560
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Fax |
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Provider Business Mailing Address
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Address Line | 9940 TALBERT AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5153
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Country | US
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Telephone | 714-964-6229
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA11773
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License Number State | CA
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