Organization
GLENN PSYCHIATRIC MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYANA KO NP (VICE PRESIDENT)
(424) 728-5564
Entity
Organization
Contact information
Practice address
2200 PACIFIC COAST HWY STE 103, HERMOSA BEACH, CA 90254-2700
(424) 728-5564
(424) 377-6548
Mailing address
2200 PACIFIC COAST HWY STE 103, HERMOSA BEACH, CA 90254-2700
(424) 728-5564
(424) 377-6548
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/12/2025
Last updated
11/12/2025
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