Provider Demographics
NPI:1417004151
Name:GLASBERG, MARK R (MD)
Entity Type:Individual
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First Name:MARK
Middle Name:R
Last Name:GLASBERG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:121 N ALMONT DR
Mailing Address - Street 2:#205
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1856
Mailing Address - Country:US
Mailing Address - Phone:310-276-4765
Mailing Address - Fax:310-276-4465
Practice Address - Street 1:28001 SMYTH DR
Practice Address - Street 2:#108
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4024
Practice Address - Country:US
Practice Address - Phone:661-702-9211
Practice Address - Fax:661-702-9255
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG175262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology