Provider Demographics
NPI:1548385123
Name:SCHAFER, PAMELA R (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:R
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 STRATFORD CT
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2327
Mailing Address - Country:US
Mailing Address - Phone:858-523-9409
Mailing Address - Fax:858-523-9403
Practice Address - Street 1:1343 STRATFORD CT
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2327
Practice Address - Country:US
Practice Address - Phone:858-523-9409
Practice Address - Fax:858-523-9403
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85240174400000X
ND4624174400000X
MN32327174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
W15668Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER
CAF13103Medicare UPIN