MEDICARE: GLENDALE ADVENTIST MEDICAL CENTER

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	282N00000X	General Acute Care Hospital	930000059	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831188275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLENDALE ADVENTIST MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1509 WILSON TER
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4007
Country	:	US
Telephone Number	:	818-409-8000
Fax Number	:	818-546-5600

Provider Business Practice Location Address
First Line	:	1509 WILSON TER
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4007
Country	:	US
Telephone Number	:	818-409-8000
Fax Number	:	818-546-5600

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALICE H ISSAI
Credential	:
Telephone Number	:	818-409-8000

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	11/13/2025

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Directions to “GLENDALE ADVENTIST MEDICAL CENTER ” Practice Location

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