Glendale Rejuvenation Medical Group

LBN: Glendale Rejuvenation Medical Group
Glendale Rejuvenation Medical Group is an health care organization with primary practice located at 1703 N Avalon Blvd , Wilmington CA 90744-1432. The organization recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Chiropractic Providers / Nutrition, Dietary & Nutritional Service Providers / Dietitian, Registered, Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Obesity Medicine, Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Obesity Medicine is the primary health care specialty. Glendale Rejuvenation Medical Group can be contacted via phone (310) 233-9355, or through Santiago, Eddie via phone (818) 610-9360.

Contact Information

Primary practice address
1703 N Avalon Blvd Wilmington CA 90744-1432
Phone: (310) 233-9355
Fax: (310) 233-2545
Website:
Map and Directions
Authorized official contact:
Name: Santiago, Eddie MANAGER
Phone: (818) 610-9360

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Chiropractic Providers / Nutrition 111NN1001X
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X
Allopathic & Osteopathic Physicians / Obesity Medicine 207QB0002X
Allopathic & Osteopathic Physicians / Sports Medicine 2083S0010X
Allopathic & Osteopathic Physicians / General Practice 208D00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1073960407
LBN Legal business name Glendale Rejuvenation Medical Group
DBA Doing business as Glendale Rejuvenation Medical Group
Authorized official Santiago, Eddie MANAGER
Entity Organization
Organization subpart 1 No
Enumeration date May 16th, 2016
Last updated Dec 21st, 2021 - about 3 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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