Provider Demographics
NPI:1730482100
Name:WESTERN ACUTE CARE PHYSICIANS, INC.
Entity Type:Organization
Organization Name:WESTERN ACUTE CARE PHYSICIANS, INC.
Other - Org Name:WESTERN ACUTE CARE PHYSICIANS MEDICAL GROUP, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLAVINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-925-8355
Mailing Address - Street 1:PO BOX 4419
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91365-4419
Mailing Address - Country:US
Mailing Address - Phone:818-340-9988
Mailing Address - Fax:818-587-2493
Practice Address - Street 1:9542 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6511
Practice Address - Country:US
Practice Address - Phone:562-925-8355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty