Organization
GLENDALE COMMUNITY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUC CONG BUI M.D. (PRESIDENT)
(818) 265-2204
Entity
Organization
Contact information
Practice address
801 S CHEVY CHASE DR, SUITE 105, GLENDALE, CA 91205-4431
(818) 265-2204
(818) 265-2201
Mailing address
801 S CHEVY CHASE DR, SUITE 105, GLENDALE, CA 91205-4431
(818) 265-2204
(818) 265-2201
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
23056633
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A459580
—
CA
Enumeration date
11/03/2005
Last updated
02/09/2011
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