JERALD R STAFFORD MD INC
Osteopathic Medicine at Health Center Dr, Laguna Beach, CA

License number
California A25139
Category
Osteopathic Medicine
Type
Critical Care Medicine
License number
California A25139
Category
Osteopathic Medicine
Type
Pulmonary Disease
Owner
Name: JERALD ROBERT STAFFORD MD
Title: PRESIDENT
Phone: (949) 458-1223
Address
Address
24411 Health Center Dr SUITE 560, Laguna Beach, CA 92653
National Provider ID: 1366480790
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JERALD R. STAFFORD, M.D., INC

San Clemente, CA  -  Laguna Beach, CA

Status:
Inactive
Registration:
May 14, 1982
Addresses:
422 Camino Vis Verde, San Clemente, CA 92673 (Physical)
24411 Health Ctr Dr, Laguna Beach, CA 92653
State ID:
C1073122
Business type:
Articles of Incorporation
President:
Jerald Stafford (President)
Agent:
Earlene Victoria Stafford,San Clemente, CA 92673 (Physical)

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