MEDICARE: MR. JAMES MICHAEL GLICK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	G026584	CA

General Provider Information

NPI Number	:	1306869599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES MICHAEL GLICK MD

Provider Business Mailing Address
First Line	:	2299 POST ST
Second Line	:	#107
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3443
Country	:	US
Telephone Number	:	415-345-9400
Fax Number	:	415-345-8049

Provider Business Practice Location Address
First Line	:	2299 POST ST
Second Line	:	#107
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3443
Country	:	US
Telephone Number	:	415-345-9400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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