Provider Demographics
NPI:1346380631
Name:GLENDALE ADHC CENTER INC.
Entity Type:Organization
Organization Name:GLENDALE ADHC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YESAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-566-6688
Mailing Address - Street 1:6900 SAN FERNANDO RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1609
Mailing Address - Country:US
Mailing Address - Phone:818-566-6688
Mailing Address - Fax:818-566-6818
Practice Address - Street 1:6900 SAN FERNANDO RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1609
Practice Address - Country:US
Practice Address - Phone:818-566-6688
Practice Address - Fax:818-566-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60000671261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70237GOtherMEDICAL PROVIDER ID #