MEDICARE: DR. GLENN I POWERS M.D.

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	207L00000X	Anesthesiology Physician	G74509	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	0080384	OTHER	WA	DEPT OF LABOR & INDUSTRIE
3	0231778	OTHER	WA	L&I
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	PO3646	OTHER	WA	REGENCE BLUE SHIELD

General Provider Information

NPI Number	:	1881684926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GLENN I POWERS M.D.

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	757 WESTWOOD PLZ STE 3325
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-8358
Country	:	US
Telephone Number	:	310-267-8626
Fax Number	:	310-267-8679

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	12/02/2025

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Directions to “ DR. GLENN I POWERS M.D.” Practice Location

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