Individual
DR. GLENN ERIC WALDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 ROLLING OAKS DR, SUITE 190, THOUSAND OAKS, CA 91361-1029
(805) 494-4797
(805) 494-4810
Mailing address
415 ROLLING OAKS DR, SUITE 190, THOUSAND OAKS, CA 91361-1029
(805) 494-4797
(805) 494-4810
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A62183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A62183A
—
CA
Enumeration date
01/30/2006
Last updated
08/14/2012
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