Individual
GLENN A HUETTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
(310) 303-5750
(310) 303-5709
Mailing address
DEPT LA 21552, PASADENA, CA 91185-1552
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G47711
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G477110
BLUE SHIELD
—
05
—
00G477110
—
CA
Enumeration date
11/29/2005
Last updated
04/30/2013
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