Individual
DR. GLEN P MOREHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1180 N. INDIAN CANYON DR., E218, PALM SPRINGS, CA 92262-4800
(760) 416-4800
(770) 229-1518
Mailing address
51753 EL DORADO DR, LA QUINTA, CA 92253-9034
(760) 619-2309
(866) 428-0708
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
31076
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000447433A
—
GA
05
—
000447433C
—
GA
Enumeration date
10/18/2006
Last updated
01/22/2021
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