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General NPI Number Information
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NPI Number | 1336955277
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Entity Type | Organization
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Legal Business Name | GLOWBIRDIE PEDIATRICS
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 659 E 15TH ST STE D
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City | UPLAND
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State | CA
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Zip | 91786-2333
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Country | US
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Telephone | 909-493-1000
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Fax | 909-325-7895
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Provider Business Mailing Address
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Address Line | 659 E 15TH ST STE D
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City | UPLAND
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State | CA
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Zip | 91786-2333
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | KRISTIN GIRSHIN
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Credential |
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Telephone | 845-701-1032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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