Organization
GMBT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN RALLECA (COO)
(951) 281-4445
Entity
Organization
Contact information
Practice address
21615 BERENDO AVE STE 400, TORRANCE, CA 90502-1800
(951) 281-4445
(951) 371-5062
Mailing address
368 W 231ST ST, CARSON, CA 90745-4714
(951) 281-4445
(951) 371-5062
Taxonomy
Speciality
Code
Description
License number
State
163WD1100X
Peritoneal Dialysis Registered Nurse
Primary
163WD1100X
CA
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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