Individual
GERALD A. GLAVAZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
25455 BARTON RD, SUITE 106B, LOMA LINDA, CA 92354-3128
(909) 558-6226
(909) 558-3905
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
(909) 558-3905
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12488
CA
Other
Enumeration date
05/18/2006
Last updated
07/08/2007
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