Provider Demographics
NPI:1285839852
Name:GLAZIER, EVE MAGDALEN (MD)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:MAGDALEN
Last Name:GLAZIER
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-319-4377
Mailing Address - Fax:310-319-4425
Practice Address - Street 1:1245 16TH ST
Practice Address - Street 2:STE 125
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1235
Practice Address - Country:US
Practice Address - Phone:310-319-4377
Practice Address - Fax:310-319-4425
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2010-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA93608207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A936080Medicaid
CA00A936080Medicaid