Individual provider Active NPI

Renata Shafor, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • San Diego, CA
National Provider Identifier
1952441396
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
A41108 Issued in CA
Practice address
10052 Mesa Ridge CT
Suite 101
San Diego, CA 92121-2971
Phone
(858) 657-0550
Fax
(858) 657-0559
NPI assigned
Feb 7, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X A41108 CA Primary

Addresses

Primary practice location

10052 Mesa Ridge CT
Suite 101
San Diego, CA 92121-2971

Mailing address

11010 Arrow Rte
Suite 109
Rancho Cucamonga, CA 91730-4826
Phone (909) 481-2577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A41108CAMDSleep Medicine (Internal Medicine) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952441396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11010 ARROW RTE",
            "address_2": "SUITE 109",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304826",
            "telephone_number": "909-481-2577",
            "fax_number": "909-481-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10052 MESA RIDGE CT",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212971",
            "telephone_number": "858-657-0550",
            "fax_number": "858-657-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFOR",
        "first_name": "RENATA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "A41108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.