Healthcare Provider Details

I. General information

NPI: 1689682544
Provider Name (Legal Business Name): GLEN JOHN APRAMIAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 EAST COLORADO BLVD
PASADENA CA
91106-2225
US

IV. Provider business mailing address

1750 EAST COLORADO BLVD
PASADENA CA
91106-2225
US

V. Phone/Fax

Practice location:
  • Phone: 626-440-0097
  • Fax: 626-440-0102
Mailing address:
  • Phone: 626-440-0097
  • Fax: 626-440-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberGS0348
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberGS0348
License Number StateCA

VIII. Authorized Official

Name: DR. GLEN JOHN APRAMIAN
Title or Position: PRESIDENT
Credential: MD
Phone: 626-440-0097