Provider Demographics
NPI:1174967335
Name:SCHAEFER, CRAIG J (CPHT)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:J
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 W SUNSET BLVD STE 812
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3709
Mailing Address - Country:US
Mailing Address - Phone:310-550-1010
Mailing Address - Fax:
Practice Address - Street 1:9201 W SUNSET BLVD STE 812
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-3709
Practice Address - Country:US
Practice Address - Phone:310-550-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA165564183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician