Organization
MARCIA J GLENN MD & ASSOCIATES DERMATOLOGY & LASER MED CTR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA J GLENN M.D. (PRESIDENT)
(310) 821-7658
Entity
Organization
Contact information
Practice address
4644 LINCOLN BLVD STE 500, MARINA DEL REY, CA 90292-6391
(310) 821-7658
(310) 301-1783
Mailing address
4644 LINCOLN BLVD STE 500, MARINA DEL REY, CA 90292-6391
(310) 821-7658
(310) 821-1708
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G63373
CA
207NP0225X
Pediatric Dermatology Physician
G63373
CA
Other
Enumeration date
02/12/2009
Last updated
10/26/2018
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