Individual
GLENN I KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 W COVINA BLVD, SAN DIMAS, CA 91773-3245
(909) 599-6811
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(800) 358-9787
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G33423
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G334230
BLUE SHIELD
CA
05
—
00G334230
—
CA
01
—
930045580
RAILROAD MEDICARE
CA
Enumeration date
06/02/2006
Last updated
12/18/2008
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