Glaze, Gary M
Glaze, Gary M is an sole proprietor health care provider with primary practice located at 380 Sierra College Dr Suite 200, Grass Valley CA 95945-5092. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Glaze, Gary M can be contacted via phone (916) 613-3392.Contact Information
Primary practice address
380 Sierra College Dr Suite 200
Grass Valley CA 95945-5092
Phone: (916) 613-3392
Fax: (916) 266-9318
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 20A4983 | California |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 20A4983 | California |
Profile Details
| NPI number | 1932150257 |
|---|---|
| LBN Legal business name | Glaze, Gary M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 12th, 2006 |
| Last updated | Apr 26th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932150257 | NPPES |
| California | MEDICAID | 00AX49830 |
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