Provider Demographics
NPI:1710138748
Name:SCHEFFER, LISA G (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:G
Last Name:SCHEFFER
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 1:835 HUMBOLDT ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1442
Mailing Address - Country:US
Mailing Address - Phone:510-232-6587
Mailing Address - Fax:
Practice Address - Street 1:835 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-1442
Practice Address - Country:US
Practice Address - Phone:510-232-6587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine