MEDICARE: DR. BETHANN SCHABER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZF0201X	Forensic Pathology Physician	A063181	CA

General Provider Information

NPI Number	:	1720315971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETHANN SCHABER M.D.

Provider Business Mailing Address
First Line	:	5555 OVERLAND AVE
Second Line	:	SAN DIEGO CO MEDICAL EXAMINERS, STE. 1411
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1200
Country	:	US
Telephone Number	:	858-694-2904
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 OVERLAND AVE
Second Line	:	SAN DIEGO CO MEDICAL EXAMINERS, STE. 1411
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1200
Country	:	US
Telephone Number	:	858-694-2904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	11/09/2009

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