Provider Demographics
NPI:1790952190
Name:SCHAEFER, VIRGINIA ANN (MD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:ANN
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:31852 PACIFIC COAST HIGHWAY
Mailing Address - Street 2:200
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651
Mailing Address - Country:US
Mailing Address - Phone:949-257-7637
Mailing Address - Fax:949-499-6272
Practice Address - Street 1:31852 PACIFIC COAST HIGHWAY
Practice Address - Street 2:200
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-9265
Practice Address - Country:US
Practice Address - Phone:949-652-2320
Practice Address - Fax:949-404-8844
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG711372083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine