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General NPI Number Information
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NPI Number | 1114486495
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Entity Type | Individual
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Provider Name | GLENN JAMES GEESMAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 2900 CHANTICLEER AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1816
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Country | US
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Telephone | 831-477-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 CHANTICLEER AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1816
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Country | US
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Telephone | 831-477-2200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 202665
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License Number State | CA
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