Provider Demographics
NPI:1376645267
Name:SCHAEFER, JAMES ROLAND (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROLAND
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8851 CENTER DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3045
Mailing Address - Country:US
Mailing Address - Phone:619-463-3363
Mailing Address - Fax:619-463-4181
Practice Address - Street 1:8851 CENTER DR
Practice Address - Street 2:SUITE 210
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3045
Practice Address - Country:US
Practice Address - Phone:619-463-3363
Practice Address - Fax:619-463-4181
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA40008207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40008Medicaid
CA00A400080Medicaid
CAA40008Medicaid