Individual
SORRELL N GLOVER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 W JANSS RD, PATHOLOGY DEPT, THOUSAND OAKS, CA 91360
(805) 373-8582
(805) 373-6865
Mailing address
2190 LYNN RD, STE 220, THOUSAND OAKS, CA 91360
(805) 495-8050
(805) 496-2160
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G4456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000G44560
—
CA
Enumeration date
03/10/2006
Last updated
07/08/2007
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