Provider Demographics
NPI:1437437761
Name:STAFFORD, VIVI ROBYN (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVI
Middle Name:ROBYN
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:539 CENTENNIAL DR APT A
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-7460
Mailing Address - Country:US
Mailing Address - Phone:323-360-4670
Mailing Address - Fax:559-282-5080
Practice Address - Street 1:209 C ST
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2930
Practice Address - Country:US
Practice Address - Phone:559-386-4500
Practice Address - Fax:559-282-5080
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2016-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA85077208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice