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NPI Code Detail

MEDICARE: DR. SCOTT SHIFFMAN MD

MEDICARE: DR. SCOTT SHIFFMAN 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
1207Q00000XFamily Medicine PhysicianA45794CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164413514
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT SHIFFMAN MD
Provider Business Mailing Address
First Line : 2742 DOW AVE
Second Line :
City : TUSTIN
State : CA
Zip : 92780-7242
Country : US
Telephone Number : 714-665-1600
Fax Number :
Provider Business Practice Location Address
First Line : 29472 AVENIDA DE LAS BANDERA
Second Line :
City : RANCHO SANTA MARGARITA
State : CA
Zip : 92688-2651
Country : US
Telephone Number : 949-459-9968
Fax Number : 949-766-2565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 06/21/2011

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