=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558404277
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHREINER CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 39809 PASEO PADRE PKWY
-----------------------------------------------------
City | FREMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94538-2974
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-490-8900
-----------------------------------------------------
Fax | 510-490-9407
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 39809 PASEO PADRE PKWY
-----------------------------------------------------
City | FREMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94538-2974
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-490-8900
-----------------------------------------------------
Fax | 510-490-9407
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ROBERT RAY SCHREINER
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 510-490-2416
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC18180
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------