Waldman, Glenn Eric

Waldman, Glenn Eric is an individual health care provider with primary practice located at 415 Rolling Oaks Dr Suite 190, Thousand Oaks CA 91361-1029. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Waldman, Glenn Eric can be contacted via phone (805) 494-4797.

Contact Information

Primary practice address
415 Rolling Oaks Dr Suite 190 Thousand Oaks CA 91361-1029
Fax: (805) 494-4810
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A62183 California

Profile Details

NPI number 1881665586
LBN Legal business name Waldman, Glenn Eric
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Aug 14th, 2012 - about 14 years 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 1881665586 NPPES
California MEDICAID 00A62183A

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