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Organization

RONALD GLOUSMAN MD MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONALD ERIC GLOUSMAN MD (PRESIDENT)
(714) 313-1454
Entity
Organization

Contact information

Practice address
999 N TUSTIN AVE, STE 114, SANTA ANA, CA 92705-3528
(714) 508-1981
(866) 807-7466
Mailing address
PO BOX 570627, TARZANA, CA 91357-0627
(310) 659-9116
(866) 807-7466

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104897289
INDIVIDUAL NPI
CA
Enumeration date
01/23/2014
Last updated
08/20/2024
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