Provider Demographics
NPI:1588850267
Name:OZOA, GLENN JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:JOSEPH
Last Name:OZOA
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Gender:M
Credentials:DO
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Mailing Address - Street 1:120 S SPALDING DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1800
Mailing Address - Country:US
Mailing Address - Phone:310-659-2910
Mailing Address - Fax:310-652-2568
Practice Address - Street 1:120 S SPALDING DR
Practice Address - Street 2:SUITE 401
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1800
Practice Address - Country:US
Practice Address - Phone:310-659-2910
Practice Address - Fax:310-652-2568
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2022-02-11
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Provider Licenses
StateLicense IDTaxonomies
CA20A9737208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation