Glenn, John David

Glenn, John David is an individual health care provider with primary practice located at 975 Sereno Dr , Vallejo CA 94589-2441. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Glenn, John David can be contacted via phone (707) 651-1000.

Contact Information

Primary practice address
975 Sereno Dr Vallejo CA 94589-2441
Phone: (707) 651-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G39504 California

Profile Details

NPI number 1225188030
LBN Legal business name Glenn, John David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225188030 NPPES
California MEDICAID 00G395040

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