Organization
R G W MULTI SPECIALTY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL G WEISSBUCH M.D. (OWNER)
(818) 955-9902
Entity
Organization
Contact information
Practice address
1915 W GLENOAKS BLVD, SUITE 101, GLENDALE, CA 91201-1541
(818) 955-9902
(818) 955-9987
Mailing address
1915 W GLENOAKS BLVD, SUITE 101, GLENDALE, CA 91201-1541
(818) 955-9902
(818) 955-9987
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
A23457
CA
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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