Provider Demographics
NPI:1588034060
Name:GLEMSER, ANDREW PAUL (SFIDC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:PAUL
Last Name:GLEMSER
Suffix:
Gender:M
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SAN PASQUAL VALLEY RD
Mailing Address - Street 2:#199
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-3973
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 SAN PASQUAL VALLEY RD
Practice Address - Street 2:#199
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-3973
Practice Address - Country:US
Practice Address - Phone:760-481-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman