MEDICARE: GLENDORA SPORTS MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1477750339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLENDORA SPORTS MEDICINE

Provider Business Mailing Address
First Line	:	415 W CARROLL AVE
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-4208
Country	:	US
Telephone Number	:	626-335-7553
Fax Number	:	626-335-7757

Provider Business Practice Location Address
First Line	:	415 W CARROLL AVE
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-4208
Country	:	US
Telephone Number	:	626-335-7553
Fax Number	:	626-335-7757

Authorized Official
Title or Position	:	OWNER
Name	:	SUZI ALTER
Credential	:
Telephone Number	:	626-335-7553

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1568490548 — DR. SABRINA VERONICA HOWENSTINE M.D.
Practice Location Address:

415 W CARROLL AVE FL 2
GLENDORA, CA
91741-4208

Practice Phone: 909-394-9004
Practice Fax: 909-394-9461

1083691182 — DR. RICHARD G JOHNSON JR. M.D
Practice Location Address:

415 W CARROLL AVE
GLENDORA, CA
91741-4208

Practice Phone: 626-914-5219
Practice Fax: 626-914-7846

1689694523 — RICHARD G JOHNSON MD INC
Practice Location Address:

415 W CARROLL AVE , STE 100
GLENDORA, CA
91741-4208

Practice Phone: 626-914-5219
Practice Fax: 626-914-7846

1013061167 — VALLEY GASTOENTEROLOGY CONSULTANTS
Practice Location Address:

415 W CARROLL AVE , SUITE 201
GLENDORA, CA
91741-4208

Practice Phone: 626-963-2490
Practice Fax: 626-963-2495

1902927882 — S. MOURANI & E. TARAKJI MEDICAL PARTNERSHIP
Practice Location Address:

415 W CARROLL AVE , SUITE 201
GLENDORA, CA
91741-4208

Practice Phone: 626-963-2490
Practice Fax: 626-963-2495

1447457304 — ELIZABETH VERNETTI
Practice Location Address:

415 W CARROLL AVE
GLENDORA, CA
91741-4208

Practice Phone: 626-335-7553
Practice Fax: 626-335-7757

Directions to “GLENDORA SPORTS MEDICINE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.