Organization
GLENDALE COMMUNITY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUC C BUI M.D. (PRESIDENT)
(818) 265-2203
Entity
Organization
Contact information
Practice address
801 S CHEVY CHASE DR, 105, GLENDALE, CA 91205-4431
(818) 265-2203
(818) 265-2201
Mailing address
801 S CHEVY CHASE DR, 105, GLENDALE, CA 91205-4431
(818) 265-2203
(818) 265-2201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A45958
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A459580
—
CA
Enumeration date
09/13/2007
Last updated
12/26/2007
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