MEDICARE: DR. JOHN LESTER SCHAEFFER D.O.

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	2084P0805X	Geriatric Psychiatry Physician	20A9536	CA
2	2084P0805X	Geriatric Psychiatry Physician	38750	CO
3	2084P0800X	Psychiatry Physician	A-1243-03	NM
4	2084P0800X	Psychiatry Physician	38750	CO
5	2084P0800X	Psychiatry Physician	20A9536	CA
6	2084P0804X	Child & Adolescent Psychiatry Physician	38750	CO
7	2084P0804X	Child & Adolescent Psychiatry Physician	A-1243-03	NM
8	2084P0804X	Child & Adolescent Psychiatry Physician	20A9536	CA
9	2084P0805X	Geriatric Psychiatry Physician	A-1243-03	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497743918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LESTER SCHAEFFER D.O.

Provider Business Mailing Address
First Line	:	101 CALIFORNIA ST STE 2710
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-5818
Country	:	US
Telephone Number	:	916-320-4222
Fax Number	:	888-370-2829

Provider Business Practice Location Address
First Line	:	101 CALIFORNIA ST STE 2710
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-5818
Country	:	US
Telephone Number	:	916-320-4222
Fax Number	:	888-370-2829

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	05/04/2020

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