Provider Demographics
NPI:1073543146
Name:STAPFER, MARIA VERONICA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:VERONICA
Last Name:STAPFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 N HARBOR BLVD STE 3100
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3825
Mailing Address - Country:US
Mailing Address - Phone:714-446-5830
Mailing Address - Fax:
Practice Address - Street 1:2151 N HARBOR BLVD STE 3100
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3825
Practice Address - Country:US
Practice Address - Phone:714-446-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60530204F00000X, 204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A605300Medicaid
CA00A605300C29OtherCAL OPTIMA PIN
CA020053129OtherMEDICARE RAILROAD PIN
CA00A605300OtherBLUE SHIELD PIN
CA020053129OtherMEDICARE RAILROAD PIN
CABL960ZMedicare PIN
CA00A605300C29OtherCAL OPTIMA PIN