Provider Demographics
NPI:1588867550
Name:WALTER SCHREIBER M.D., INC.
Entity type:Organization
Organization Name:WALTER SCHREIBER M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-817-9832
Mailing Address - Street 1:9808 VENICE BLVD STE 605
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6819
Mailing Address - Country:US
Mailing Address - Phone:818-817-9832
Mailing Address - Fax:818-817-9835
Practice Address - Street 1:9808 VENICE BLVD STE 605
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6819
Practice Address - Country:US
Practice Address - Phone:818-817-9832
Practice Address - Fax:818-817-9835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21570207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A215700Medicaid
CAA21570Medicare ID - Type Unspecified
CA00A215700Medicaid