Provider Demographics
NPI:1831356757
Name:SCHAEFER, JOCHEN THORSTEN (MD)
Entity type:Individual
Prefix:
First Name:JOCHEN
Middle Name:THORSTEN
Last Name:SCHAEFER
Suffix:
Gender:
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:PO BOX 392915
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9915
Mailing Address - Country:US
Mailing Address - Phone:877-697-2447
Mailing Address - Fax:855-697-2447
Practice Address - Street 1:2121 WILSHIRE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5743
Practice Address - Country:US
Practice Address - Phone:310-828-0011
Practice Address - Fax:310-828-2001
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3581207ZD0900X
NV20391207ZD0900X
AZ61860207ZD0900X
CAA93697207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1831356757Medicaid
CT1831356757Medicaid