Individual
GLENN NORCIO FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4636 TOLAND WAY, LOS ANGELES, CA 90041-3434
(661) 312-6872
Mailing address
3371 GLENDALE BLVD # 452, LOS ANGELES, CA 90039-1846
(661) 312-6872
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A135440
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/09/2012
Last updated
07/21/2022
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