Provider Demographics
NPI:1043779218
Name:SCHREIBER, CASEY (DO)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 W LA PALMA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2658
Mailing Address - Country:US
Mailing Address - Phone:657-282-6356
Mailing Address - Fax:714-563-3367
Practice Address - Street 1:2441 W LA PALMA AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2658
Practice Address - Country:US
Practice Address - Phone:657-282-6356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A19648208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program