Individual
DR. RAY ROGERS GLENDRANGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4605 BROCKTON AVE, SUITE 100, RIVERSIDE, CA 92506-0106
(951) 686-4911
Mailing address
4605 BROCKTON AVE, SUITE 100, RIVERSIDE, CA 92506-0106
(951) 686-4911
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G61038
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G610380
—
CA
Enumeration date
04/03/2006
Last updated
07/08/2007
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