Organization
SAN GABRIEL VALLEY NEUROLOGICAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L GLATSTEIN MD (PARTNER)
(626) 960-4974
Entity
Organization
Contact information
Practice address
767 S SUNSET AVE, SUITE 5, WEST COVINA, CA 91790-3546
(626) 960-4974
(626) 338-9711
Mailing address
767 S SUNSET AVE, SUITE 5, WEST COVINA, CA 91790-3546
(626) 960-4974
(626) 338-9711
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
C31274
CA
2084N0400X
Neurology Physician
Primary
G30762
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C312740
—
CA
05
—
00G307620
—
CA
05
—
ZZZ74485Z
—
CA
Enumeration date
12/11/2006
Last updated
08/22/2020
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