Provider Demographics
NPI:1245406461
Name:SCHAEFER, DONALD WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WAYNE
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:8577 HAVEN AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4850
Mailing Address - Country:US
Mailing Address - Phone:909-481-2801
Mailing Address - Fax:
Practice Address - Street 1:8577 HAVEN AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4850
Practice Address - Country:US
Practice Address - Phone:909-481-2801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30455111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor