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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902948615 | NPPES |
| Other | 39-2063599 | TAX ID |
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