| Glendale Premier Medical Group | |
|
222 W Eulalia St #201 Glendale CA 91204-2849 | |
| (818) 240-0601 | |
| (818) 240-0687 |
| Full Name | Glendale Premier Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 222 W Eulalia St, Glendale, California |
| Authorized Official Name and Position | Lainis Quevedo (ADMINISTRATOR) |
| Authorized Official Contact | 8182400662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glendale Premier Medical Group 222 W Eulalia St #201 Glendale CA 91204-2849 Ph: (818) 240-0601 | Glendale Premier Medical Group 222 W Eulalia St #201 Glendale CA 91204-2849 Ph: (818) 240-0601 |
| NPI Number | 1003956715 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003956715 | NPI | - | NPPES |
| GR0098110 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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