Individual
GLEN R. GAERTE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1300 E COOLEY DR, COLTON, CA 92324-3905
(909) 370-4100
(909) 796-4158
Mailing address
PO BOX 2200, REDLANDS, CA 92373-0722
(909) 793-3311
(909) 796-4158
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT5669
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5D0056691
—
CA
Enumeration date
06/05/2006
Last updated
07/08/2007
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