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General NPI Number Information
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NPI Number | 1043648561
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Entity Type | Organization
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Legal Business Name | GLENDALE ORTHOPAEDICS INC.
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Dates
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Enumeration Date | 10/18/2013
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 222 W EULALIA ST SUITE 300
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City | GLENDALE
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State | CA
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Zip | 91204-2849
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Country | US
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Telephone | 818-547-0608
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Fax | 818-547-0606
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Provider Business Mailing Address
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Address Line | PO BOX 27206
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City | LOS ANGELES
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State | CA
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Zip | 90027-0206
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Country | US
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Telephone | 213-385-0675
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Fax | 213-365-6429
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Authorized Official
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Title or Position | PRIMARY DOCTOR
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Name | MICHAEL ABDILIAN
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Credential | M.D.
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Telephone | 818-547-0608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A118845
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A71238
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License Number State | CA
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