Gifford, Glenn Eric

Gifford, Glenn Eric is an individual health care provider with primary practice located at 333 Laws Ave , Ukiah CA 95482-6540. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Gifford, Glenn Eric can be contacted via phone (707) 468-1010.

Contact Information

Primary practice address
333 Laws Ave Ukiah CA 95482-6540
Phone: (707) 468-1010
Fax: (707) 462-7532
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA053012 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 61224 California

Profile Details

NPI number 1205011475
LBN Legal business name Gifford, Glenn Eric
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 7th, 2008
Last updated Apr 21st, 2026 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205011475 NPPES
Other 13654471 CAQH

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