Individual
GLEB NILOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
544 N GLENDALE AVE, GLENDALE, CA 91206-3311
(916) 406-0000
Mailing address
PO BOX 7057, VAN NUYS, CA 91409-7057
(747) 293-6893
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA62470
CA
Other
Enumeration date
11/30/2022
Last updated
05/23/2024
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