Individual
MR. GLENN GANGE IBARRIENTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
2000 ALAMEDA DE LAS PULGAS, SAN MATEO, CA 94403-1269
(650) 573-2828
(650) 573-2042
Mailing address
2000 ALAMEDA DE LAS PULGAS, SAN MATEO, CA 94403-1269
(650) 573-2828
(650) 573-2042
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
450944
CA
Other
Enumeration date
11/19/2007
Last updated
08/24/2009
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