Organization
GLENDALE MUTUAL CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARLATH NOEL RYAN M.D. (PRESIDENT)
(626) 646-8233
Entity
Organization
Contact information
Practice address
230 N MARYLAND AVE, SUITE 105, GLENDALE, CA 91206-4261
(626) 616-6642
Mailing address
PO BOX 10717, GLENDALE, CA 91209-3717
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A98448
CA
Other
Enumeration date
07/27/2008
Last updated
07/27/2008
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