Vallecillos, Glenn

Vallecillos, Glenn is an sole proprietor health care provider with primary practice located at 9675 Brighton Way Ste 380 , Beverly Hills CA 90210-5187. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Vallecillos, Glenn can be contacted via phone (310) 273-3007.

Contact Information

Primary practice address
9675 Brighton Way Ste 380 Beverly Hills CA 90210-5187
Phone: (310) 273-3007
Fax: (310) 733-1818
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X A87379 California

Profile Details

NPI number 1902948615
LBN Legal business name Vallecillos, Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2007
Last updated Jan 17th, 2022 - about 2 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 1902948615 NPPES
Other 39-2063599 TAX ID

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