Provider Demographics
NPI:1679683247
Name:GLASER, A JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:A
Middle Name:JOSEPH
Last Name:GLASER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ARTHUR
Other - Middle Name:JOSEPH
Other - Last Name:HLASER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:4444 W RIVERSIDE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4048
Mailing Address - Country:US
Mailing Address - Phone:818-843-2100
Mailing Address - Fax:603-250-8828
Practice Address - Street 1:4444 W RIVERSIDE DR STE 206
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4048
Practice Address - Country:US
Practice Address - Phone:818-843-2100
Practice Address - Fax:603-250-8828
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9502103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9502AMedicare ID - Type Unspecified