=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992713341
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFREY S. SCHIFFMAN M.D. INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 255 N ELM ST STE 201
-----------------------------------------------------
City | ESCONDIDO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92025-3431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-741-8500
-----------------------------------------------------
Fax | 760-741-1129
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 255 N ELM ST STE 201
-----------------------------------------------------
City | ESCONDIDO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92025-3431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-741-8500
-----------------------------------------------------
Fax | 760-741-1129
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JEFFREY SCOTT SCHIFFMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 760-741-8500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XS0117X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery of the Spine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------