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General NPI Number Information
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NPI Number | 1114841624
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Entity Type | Organization
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Legal Business Name | GLENN MEDICAL GROUP
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 1052 WOODBURY DR
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City | HARBOR CITY
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State | CA
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Zip | 90710-1241
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Country | US
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Telephone | 310-922-5054
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Fax | 424-263-4331
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Provider Business Mailing Address
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Address Line | 1052 WOODBURY DR
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City | HARBOR CITY
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State | CA
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Zip | 90710-1241
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Country | US
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Telephone | 310-922-5054
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Fax | 434-363-4331
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CASPER TURNAGE GLENN
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Credential | MD
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Telephone | 310-922-5054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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