Provider Demographics
NPI:1639465487
Name:ORDINARIO, GLEN (NP)
Entity Type:Individual
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First Name:GLEN
Middle Name:
Last Name:ORDINARIO
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Gender:M
Credentials:NP
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Mailing Address - Street 1:11550 INDIAN HILLS RD
Mailing Address - Street 2:371
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1200
Mailing Address - Country:US
Mailing Address - Phone:818-365-1194
Mailing Address - Fax:818-898-3835
Practice Address - Street 1:11550 INDIAN HILLS RD
Practice Address - Street 2:371
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1200
Practice Address - Country:US
Practice Address - Phone:818-365-1194
Practice Address - Fax:818-898-3835
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2013-01-08
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Provider Licenses
StateLicense IDTaxonomies
CA20484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily