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General NPI Number Information
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NPI Number | 1427565506
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Entity Type | Organization
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Legal Business Name | GLENDALE HOSPITALIST MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 1509 WILSON TER
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City | GLENDALE
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State | CA
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Zip | 91206
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Country | US
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Telephone | 818-863-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80143
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91716-8143
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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 | PRESIDENT
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Name | MARK BELL
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Credential | MD
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Telephone | 904-421-1983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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