Healthcare Provider Details

I. General information

NPI: 1376645267
Provider Name (Legal Business Name): JAMES ROLAND SCHAEFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 CENTER DR SUITE 210
LA MESA CA
91942-3045
US

IV. Provider business mailing address

8851 CENTER DR SUITE 210
LA MESA CA
91942-3045
US

V. Phone/Fax

Practice location:
  • Phone: 619-463-3363
  • Fax: 619-463-4181
Mailing address:
  • Phone: 619-463-3363
  • Fax: 619-463-4181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA40008
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: