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Individual

DR. JOHN LUKE GLAVINOVICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4330 BARRANCA PARKWAY, SUITE 112, IRVINE, CA 92604-4755
(949) 307-6210
(949) 497-4225
Mailing address
456 PANORAMA DR, LAGUNA BEACH, CA 92651-1278
(949) 307-6210
(949) 497-4225

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G31910
CA
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
G31910
CA
208D00000X
General Practice Physician
G31910
CA
405300000X
Prevention Professional
Primary
G31910
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G319100
BLUE SHIELD
CA
05
00G319100
CA
01
930107459
RAILROAD MEDICARE
CA
Enumeration date
07/20/2006
Last updated
02/26/2019
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