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Organization
RONALD GLOUSMAN MD MEDICAL CORPORATION
Active
Organization
RONALD GLOUSMAN MD MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD ERIC GLOUSMAN MD (PRESIDENT)
(714) 313-1454
Entity
Organization
Contact information
Practice address
999 N TUSTIN AVE, STE 114, SANTA ANA, CA 92705-3528
(714) 508-1981
(866) 807-7466
Mailing address
PO BOX 570627, TARZANA, CA 91357-0627
(310) 659-9116
(866) 807-7466
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104897289
INDIVIDUAL NPI
CA
Enumeration date
01/23/2014
Last updated
08/20/2024
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