Organization
GLENDALE RETINA ASSOCIATES MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY LOGANI MD (PRESIDENT)
(818) 886-6700
Entity
Organization
Contact information
Practice address
1025 N BRAND BLVD, SUITE 200, GLENDALE, CA 91202-2950
(818) 230-2140
(818) 230-2148
Mailing address
1025 N BRAND BLVD, SUITE 200, GLENDALE, CA 91202-2950
(818) 230-2140
(818) 230-2148
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0104990
—
CA
Enumeration date
08/16/2006
Last updated
09/21/2007
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