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Individual

JERROLD GLASSMAN

Active
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Individual

JERROLD GLASSMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G34309
CA
207RI0011X
Interventional Cardiology Physician
G34309
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G343090
BLUE SHIELD
CA
05
00G343090
CA
01
953712511
TRICARE
CA
Enumeration date
10/04/2006
Last updated
11/04/2010
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