GLENDALE REJUVENATION MEDICAL GROUP; NPI #1073960407

Contact Information

GLENDALE REJUVENATION MEDICAL GROUP

1703 N AVALON BLVD
WILMINGTON, CA 90744-1432

Phone: 310-233-9355
Fax: 310-233-2545
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Bariatric Medicine	207QB0002X	08	Physician/Family Practice
Allergy & Immunology	207K00000X	03	Physician/Allergy/ Immunology
Chiropractor - Nutrition	111NN1001X	35	Chiropractic
Dietitian, Registered	133V00000X	71	Registered Dietitian or Nutrition Professional
General Practice	208D00000X	99	Physician/Undefined Physician type[6]
Physician Assistant	363A00000X	97	Physician Assistant
Social Worker	104100000X
Sports Medicine	2083S0010X	84	Physician/Preventive Medicine

Indicates primary specialty

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NPI Profile & details for GLENDALE REJUVENATION MEDICAL GROUP

NPI #	`1073960407`
LBN Legal business name	GLENDALE REJUVENATION MEDICAL GROUP
Authorized official	EDDIE SANTIAGO - (MANAGER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	05/16/2016
Last updated	12/21/2021 - About 4 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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GLENDALE REJUVENATION MEDICAL GROUP

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NPI Profile & details for GLENDALE REJUVENATION MEDICAL GROUP

Reviews for GLENDALE REJUVENATION MEDICAL GROUP