Individual
GARY ANDREW GLENESK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 CREEKSIDE DR, FOLSOM, CA 95630-3400
(916) 983-7461
(916) 983-7569
Mailing address
PO BOX 1809, ORANGE, CA 92856-0809
(714) 560-1580
(714) 560-1585
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G53123
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G531230
BLUE SHIELD
CA
05
—
00G531231
—
CA
Enumeration date
07/29/2006
Last updated
02/03/2009
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