Individual
CAROL ELIZABETH GLANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3055 MACARTHUR BLVD, OAKLAND, CA 94602-3211
(510) 530-1111
(510) 530-1118
Mailing address
3055 MACARTHUR BLVD, OAKLAND, CA 94602-3211
(510) 530-1111
(510) 530-1118
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G71014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0083690
MEDICAID
CA
Enumeration date
10/28/2006
Last updated
04/17/2012
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