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General NPI Number Information
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NPI Number | 1972072999
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Entity Type | Organization
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Legal Business Name | SAULENA SHAFER D.O., INC.
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 510 SUPERIOR AVE STE 200A
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3664
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Country | US
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Telephone | 951-203-1823
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Fax |
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Provider Business Mailing Address
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Address Line | 3235 GRAND CANAL
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City | IRVINE
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State | CA
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Zip | 92620-1707
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Country | US
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Telephone | 951-203-1823
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | SAULENA SYLVIA SHAFER
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Credential | DO
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Telephone | 951-203-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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