MEDICARE: DR. SHAHNAWAZ S JAFFER M.D.

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	207RG0100X	Gastroenterology Physician	A26483	CA

General Provider Information

NPI Number	:	1649301698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAHNAWAZ S JAFFER M.D.

Provider Business Mailing Address
First Line	:	247 W SAN BERNARDINO RD
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-1516
Country	:	US
Telephone Number	:	626-915-7100
Fax Number	:	626-478-1499

Provider Business Practice Location Address
First Line	:	247 W SAN BERNARDINO RD
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-1516
Country	:	US
Telephone Number	:	626-915-7100
Fax Number	:	626-478-1499

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/06/2010

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