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GLENDALE REJUVENATION MEDICAL GROUP NPI 1457011256


NPI Information

NPI: 1457011256
Provider Name: GLENDALE REJUVENATION MEDICAL GROUP
Classification: Non-Pharmacy Dispensing Site - 332900000X
Entity Type: Organization
Address:
1703 N AVALON BLVD
WILMINGTON, CA
ZIP 90744
Phone: (818) 518-5980
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GLENDALE REJUVENATION MEDICAL GROUP is a non pharmacy dispensing site in Wilmington, CA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) GLENDALE REJUVENATION MEDICAL GROUP NPI is 1457011256. The provider is registered as an organization entity type.

The provider's business location address is:

1703 N AVALON BLVD
WILMINGTON, CA
ZIP 90744-432
Phone: (818) 518-5980

The provider's authorized official is Jeffrey Feinberg .
The authorized official title is Administrator and has the following contact phone number (818) 430-6312.

The enumeration date for this NPI number is 12/21/2021 and was last updated on 12/21/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332900000XNon-Pharmacy Dispensing SiteYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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