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General NPI Number Information
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NPI Number | 1588606834
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Entity Type | Organization
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Legal Business Name | GLENDALE EMERGENCY MEDICAL ASSOCIATES, INC
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1420 S CENTRAL AVE
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City | GLENDALE
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State | CA
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Zip | 91204-2508
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Country | US
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Telephone | 818-502-2344
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Fax | 818-502-4501
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Provider Business Mailing Address
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Address Line | PO BOX 845774
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City | LOS ANGELES
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State | CA
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Zip | 90084-5774
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Country | US
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Telephone | 844-486-7184
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL S AGRON
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Credential | M.D.
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Telephone | 909-629-8088
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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 | CA
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