Individual
DR. JAY E GLADSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5901 W OLYMPIC BLVD, 206, LOS ANGELES, CA 90036-4667
(323) 215-1725
(323) 271-4154
Mailing address
5901 W OLYMPIC BLVD, 206, LOS ANGELES, CA 90036-4667
(323) 215-1725
(323) 271-4154
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A83112
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013144187
—
CA
01
—
CB682Z
MEDICARE PTAN
CA
01
—
P00745200
RAILROAD MEDICARE
CA
Enumeration date
09/19/2006
Last updated
11/15/2016
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