Glendale Premier Medical Group

LBN: Glendale Premier Medical Group
Glendale Premier Medical Group is an health care organization with primary practice located at 222 W Eulalia St #201, Glendale CA 91204-2849. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Glendale Premier Medical Group can be contacted via phone (818) 240-0601, or through Quevedo, Lainis via phone (818) 240-0662.

Contact Information

Primary practice address
222 W Eulalia St #201 Glendale CA 91204-2849
Phone: (818) 240-0601
Fax: (818) 240-0687
Website:
Map and Directions
Authorized official contact:
Name: Quevedo, Lainis
Phone: (818) 240-0662

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1003956715
LBN Legal business name Glendale Premier Medical Group
DBA Doing business as
Authorized official Quevedo, Lainis
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003956715 NPPES
California MEDICAID GR0098110

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