Healthcare Provider Details

I. General information

NPI: 1790952190
Provider Name (Legal Business Name): VIRGINIA ANN SCHAEFER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 CAMINO DE LOS MARES STE 200
SAN CLEMENTE CA
92673-2836
US

IV. Provider business mailing address

675 CAMINO DE LOS MARES STE 200
SAN CLEMENTE CA
92673-2836
US

V. Phone/Fax

Practice location:
  • Phone: 949-652-2320
  • Fax: 949-715-0231
Mailing address:
  • Phone: 949-652-2320
  • Fax: 949-715-0231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberG71137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: