Provider Demographics
NPI:1477676393
Name:GLONCHAK, AMITA APTE (RCP, RRT, RPFT)
Entity Type:Individual
Prefix:
First Name:AMITA
Middle Name:APTE
Last Name:GLONCHAK
Suffix:
Gender:F
Credentials:RCP, RRT, RPFT
Other - Prefix:
Other - First Name:AMITA
Other - Middle Name:
Other - Last Name:APTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RCP, RRT, RPFT
Mailing Address - Street 1:952 DENVER DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-2927
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:952 DENVER DR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-2927
Practice Address - Country:US
Practice Address - Phone:714-754-7882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000225682279P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function Technologist