MEDICARE: LAURALEE FLAHERTY RECHTSCHAFFEN NP

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	363L00000X	Nurse Practitioner	393267	CA

General Provider Information

NPI Number	:	1548538796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURALEE FLAHERTY RECHTSCHAFFEN NP

Provider Business Mailing Address
First Line	:	253 W MARQUITA
Second Line	:	UNIT B
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92672-5184
Country	:	US
Telephone Number	:	949-521-2367
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 SOUTH COAST HWY
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-0000
Country	:	US
Telephone Number	:	949-521-2367
Fax Number	:

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

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	12/02/2011

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