Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 2009139 | CA |
N | 207SG0201X | Clinical Genetics (M.D.) | MD153180 | OR |
N | 207SG0201X | Clinical Genetics (M.D.) | MD60278147 | WA |
N | 207V00000X | Obstetrician & Gynecologist | MD153180 | OR |
N | 207V00000X | Obstetrician & Gynecologist | MD60278147 | WA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 854587 | CA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD153180 | OR |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD60278147 | WA |
NPI | 1245296052 |
---|---|
Provider Name | Dr. Brian L Shaffer |
First Address | Los Altos, CA 94022-1408 |
Second Address | San Francisco, CA 94109-6978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 24/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A825830 | (05) | CA |
500627546 | (05) | OR |
A82583 | STATE MEDICAL LICENSE (01) | CA |
I28417 | (02) | CA |
MD153180 | STATE MEDICAL LICENSE (01) | OR |