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Individual

ERIC VICTOR GLASSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
22 CORPORATE PLAZA DR, NEWPORT BEACH, CA 92660-7985
(949) 722-7038
(949) 630-4951
Mailing address
22 CORPORATE PLAZA DR, NEWPORT BEACH, CA 92660-7985
(949) 722-7038
(949) 630-4951

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA17028
CA
363AS0400X
Surgical Physician Assistant
Primary
PA17028
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GX035Z
PTAN
CA
Enumeration date
06/27/2006
Last updated
12/08/2021
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