Provider Demographics
NPI:1528044815
Name:GLAZER, ROBERT N (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:GLAZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 SKYPARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5023
Mailing Address - Country:US
Mailing Address - Phone:310-784-6316
Mailing Address - Fax:310-784-6314
Practice Address - Street 1:3333 SKYPARK DR
Practice Address - Street 2:STE 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5023
Practice Address - Country:US
Practice Address - Phone:310-784-6316
Practice Address - Fax:310-784-6314
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG66155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E47393Medicare UPIN
CAWG66155AMedicare ID - Type Unspecified