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General NPI Number Information
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NPI Number | 1538266101
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Entity Type | Individual
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Provider Name | GLENN R WILLIAMS D.C., L.AC.
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Gender | Male
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10801 NATIONAL BLVD #607
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City | LOS ANGELES
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State | CA
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Zip | 90064-4139
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Country | US
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Telephone | 310-474-2221
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Fax | 310-446-5323
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Provider Business Mailing Address
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Address Line | PO BOX 351475
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City | LOS ANGELES
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State | CA
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Zip | 90035-9175
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Country | US
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Telephone | 310-474-2221
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Fax | 310-446-5323
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC12099
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 1590
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License Number State | CA
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