MEDICARE: MRS. KAREN LEE SCHAFER NP

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	363LF0000X	Family Nurse Practitioner	95019030	CA

General Provider Information

NPI Number	:	1922764885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN LEE SCHAFER NP

Provider Business Mailing Address
First Line	:	6366 PROVENCE RD
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91775-1712
Country	:	US
Telephone Number	:	626-203-8543
Fax Number	:

Provider Business Practice Location Address
First Line	:	10250 SANTA MONICA BLVD STE 1440
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-6499
Country	:	US
Telephone Number	:	310-295-2075
Fax Number	:

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

Provider Enumeration Date	:	11/15/2021
Last Update Date	:	11/18/2021

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