Individual
ANTHONY STAUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 W COAST HWY, NEWPORT BEACH, CA 92663-4007
(949) 646-4400
(949) 646-4485
Mailing address
PO BOX 6593, ORANGE, CA 92863-6593
(714) 571-5000
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G37591
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G375910
BLUE SHIELD
CA
05
—
00G375910
—
CA
01
—
300016070
RR MEDICARE
CA
01
—
P00464330
RAILROAD MEDICARE
—
Enumeration date
11/09/2005
Last updated
05/09/2014
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