Organization
ENERGY WELLNESS REJUVENATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN L GLAVINOVICH MD (PRESIDENT)
(949) 307-6210
Entity
Organization
Contact information
Practice address
456 PANORAMA DR, LAGUNA BEACH, CA 92651-1278
(949) 307-6210
(949) 497-4225
Mailing address
456 PANORAMA DR, LAGUNA BEACH, CA 92651-1278
(949) 307-6210
(949) 497-4225
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G31910
CA
Other
Enumeration date
07/06/2016
Last updated
07/08/2016
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