MEDICARE: ARON SCHUFTAN MEDICAL CORPORATION

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1639490931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARON SCHUFTAN MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	415 TESCONI CIR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95401-4619
Country	:	US
Telephone Number	:	707-578-1175
Fax Number	:	707-578-1147

Provider Business Practice Location Address
First Line	:	401 WARREN ST
Second Line	:	SUITE 302
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-1578
Country	:	US
Telephone Number	:	650-701-1882
Fax Number	:	650-701-1886

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARON SCHUFTAN
Credential	:	MD
Telephone Number	:	650-701-1882

Provider Enumeration Date	:	06/21/2010
Last Update Date	:	12/16/2011

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