Organization
GLEN I KOMATSU M D A PROFESSIONAL CORPORATION
Active
Parent organization
PROVIDENCE HEALTH AND SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH AND SERVICES
Authorized official
GLEN I KOMATSU MD (OWNER)
(310) 375-4585
Entity
Organization
Contact information
Practice address
4101 TORRANCE BLVD, PALLIATIVE CARE, TORRANCE, CA 90503-4607
(310) 303-6840
(310) 303-5574
Mailing address
6069 WOODFERN DR, RANCHO PALOS VERDES, CA 90275-2263
(310) 545-9713
(310) 546-1648
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/01/2007
Last updated
09/07/2023
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