MEDICARE: ANTHONY STAUFFER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	G37591	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00464330	OTHER		RAILROAD MEDICARE
4	300016070	OTHER	CA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	00G375910	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1083695720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY STAUFFER MD

Provider Business Mailing Address
First Line	:	PO BOX 6593
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92863-6593
Country	:	US
Telephone Number	:	714-571-5000
Fax Number	:	714-571-5055

Provider Business Practice Location Address
First Line	:	3300 W COAST HWY
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4007
Country	:	US
Telephone Number	:	949-646-4400
Fax Number	:	949-646-4485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	05/09/2014

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Directions to “ ANTHONY STAUFFER MD” Practice Location

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