Organization
GLOM SUBSTANCE ABUSE PROGRAM
Active
Other names
G.L.O.M. OUTPATIENT SERVICES INC.
Organization subpart
No
Provider details
NPI number
Authorized official
JAGDEEP KAUR (MD)
(925) 570-3282
Entity
Organization
Contact information
Practice address
1020 W MAIN ST, MERCED, CA 95340-4521
(925) 570-3282
(925) 800-3102
Mailing address
3123 INDEPENDENCE DR, LIVERMORE, CA 94551-7595
(925) 570-3282
(925) 800-3102
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2630352
MEDI-CAL
CA
Enumeration date
10/08/2020
Last updated
10/04/2024
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