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Organization
SOUTHERN CALIFORNIA ACUTE CARE PHYSICIANS
Active
Organization
SOUTHERN CALIFORNIA ACUTE CARE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L GLAVINOVICH MD (PRESIDENT)
(949) 497-4225
Entity
Organization
Contact information
Practice address
14662 NEWPORT AVE, TUSTIN, CA 92780-6064
(714) 669-2000
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(866) 266-6980
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH8363
RAILROAD MEDICARE
CA
01
—
DC9564
RAILROAD MEDICARE
CA
05
—
GR008930
—
CA
05
—
GR0089931
—
CA
05
—
GR0089932
—
CA
01
—
ZZZ01337Z
BLUE SHIELD
CA
01
—
ZZZ01338Z
BLUE SHIELD
CA
01
—
ZZZ03049Z
BLUE SHIELD
CA
Enumeration date
05/28/2006
Last updated
08/22/2020
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