Provider Demographics
NPI:1629309919
Name:GLOWING CARE INC
Entity Type:Organization
Organization Name:GLOWING CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-218-3980
Mailing Address - Street 1:22647 VENTURA BLVD
Mailing Address - Street 2:STE 197
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1416
Mailing Address - Country:US
Mailing Address - Phone:808-218-3980
Mailing Address - Fax:
Practice Address - Street 1:1132 BISHOP ST
Practice Address - Street 2:STE 303
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2807
Practice Address - Country:US
Practice Address - Phone:808-218-3980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD10673207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty