Provider Demographics
NPI:1740592492
Name:SCHAFER, DENNIS PHILIP (RPH)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:PHILIP
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3576
Mailing Address - Country:US
Mailing Address - Phone:415-454-7744
Mailing Address - Fax:415-476-0908
Practice Address - Street 1:471 3RD ST
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3576
Practice Address - Country:US
Practice Address - Phone:415-454-7744
Practice Address - Fax:415-476-0908
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist