Healthcare Provider Details
I. General information
NPI: 1760725030
Provider Name (Legal Business Name): MICHAEL SCHREIBER, DO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2013
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2560 W OLYMPIC BLVD 201
LOS ANGELES CA
90006-2972
US
IV. Provider business mailing address
2560 W OLYMPIC BLVD 201
LOS ANGELES CA
90006-2972
US
V. Phone/Fax
- Phone: 213-383-0007
- Fax: 866-505-1544
- Phone: 213-383-0007
- Fax: 866-505-1544
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | 20A5391 |
| License Number State | CA |
VIII. Authorized Official
Name:
MICHAEL
SCHREIBER
Title or Position: PRESIDENT
Credential: DO
Phone: 310-453-8393