Individual
RICHARD SHAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1910 N BUSH ST, SANTA ANA, CA 92706-2816
(714) 361-7950
Mailing address
1607 ELECTRIC AVE APT 2, SEAL BEACH, CA 90740-6560
(714) 272-7025
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-RLJUOV
CA
Other
Enumeration date
03/28/2023
Last updated
07/11/2023
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