Healthcare Provider Details

I. General information

NPI: 1073456778
Provider Name (Legal Business Name): CHRISTINA GLOADY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 N VERMONT AVE
LOS ANGELES CA
90004-2115
US

IV. Provider business mailing address

2650 E SHACKLE LINE DR
BREA CA
92821-7408
US

V. Phone/Fax

Practice location:
  • Phone: 323-284-7998
  • Fax:
Mailing address:
  • Phone: 562-708-6204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: