Provider Demographics
NPI:1740352293
Name:SCHAEFFER, CYNTHIA LYNN (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNN
Last Name:SCHAEFFER
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 1:292 EUCLID AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-3629
Mailing Address - Country:US
Mailing Address - Phone:619-266-3332
Mailing Address - Fax:619-266-6000
Practice Address - Street 1:292 EUCLID AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-3643
Practice Address - Country:US
Practice Address - Phone:619-266-3332
Practice Address - Fax:619-266-6000
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91771174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA91771AMedicare ID - Type UnspecifiedMEDICARE
CAI40246Medicare UPIN