Provider Demographics
NPI:1033184973
Name:LITTENBERG, GLENN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:DAVID
Last Name:LITTENBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:630 S RAYMOND AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3278
Mailing Address - Country:US
Mailing Address - Phone:626-449-9920
Mailing Address - Fax:626-578-7366
Practice Address - Street 1:630 S RAYMOND AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3278
Practice Address - Country:US
Practice Address - Phone:626-449-9920
Practice Address - Fax:626-578-7366
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG27849207RG0100X, 207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G278490Medicaid
CA00G278490Medicaid
CAA43518Medicare UPIN