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Organization
GLENDALE COMMUNITY MEDICAL GROUP, INC.
Active
Organization
GLENDALE COMMUNITY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUC CONG BUI M.D. (PRESIDENT)
(818) 265-2204
Entity
Organization
Contact information
Practice address
801 S CHEVY CHASE DR, SUITE 105, GLENDALE, CA 91205-4431
(818) 265-2204
(818) 265-2201
Mailing address
801 S CHEVY CHASE DR, SUITE 105, GLENDALE, CA 91205-4431
(818) 265-2204
(818) 265-2201
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
23056633
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A459580
—
CA
Enumeration date
11/03/2005
Last updated
02/09/2011
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