Basic Information
Provider Information
NPI: 1689648750
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHIFFMAN
FirstName: HOWARD
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 23540
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921933540
CountryCode: US
TelephoneNumber: 8585650950
FaxNumber: 8582441100
Practice Location
Address1: 8745 AERO DRIVE
Address2: SUITE 200
City: SAN DIEGO
State: CA
PostalCode: 921231774
CountryCode: US
TelephoneNumber: 8585650950
FaxNumber: 8582441100
Other Information
ProviderEnumerationDate: 02/15/2006
LastUpdateDate: 10/10/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XC40004CAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085B0100XC40004CAN Allopathic & Osteopathic PhysiciansRadiologyBody Imaging
2085U0001XC40004CAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
2085N0700XC40004CAN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085N0904XC40004CAN Allopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
2085P0229XC40004CAN Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology

ID Information
IDTypeStateIssuerDescription
GR008381105CA MEDICAID
GR008381205CA MEDICAID
GR008381505CA MEDICAID
GR008381605CA MEDICAID
GR008381305CA MEDICAID
ZZZ75341Z05CA MEDICAID
GR008381005CA MEDICAID
GR008381405CA MEDICAID
GR008381705CA MEDICAID


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