Healthcare Provider Details

I. General information

NPI: 1396180352
Provider Name (Legal Business Name): MR. JEFF SCHUBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2013
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E COLORADO ST STE 710
GLENDALE CA
91205-1675
US

IV. Provider business mailing address

425 E COLORADO ST STE 710
GLENDALE CA
91205-1675
US

V. Phone/Fax

Practice location:
  • Phone: 818-547-9544
  • Fax:
Mailing address:
  • Phone: 818-547-9544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: