Individual
DR. GLEN GORMEZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3875 TELEGRAPH AVE, OAKLAND, CA 94609-2428
(510) 547-2244
Mailing address
PO BOX 398398, SAN FRANCISCO, CA 94139-8398
(888) 991-1101
(903) 787-5854
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G58609
CA
Other
Enumeration date
10/02/2006
Last updated
09/25/2019
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