Provider Demographics
NPI:1851430094
Name:JAMES M. GLICK, M.D., AP-C
Entity Type:Organization
Organization Name:JAMES M. GLICK, M.D., AP-C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, AP-C
Authorized Official - Phone:415-345-9400
Mailing Address - Street 1:2299 POST ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3441
Mailing Address - Country:US
Mailing Address - Phone:415-345-9400
Mailing Address - Fax:415-345-8049
Practice Address - Street 1:2299 POST ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3441
Practice Address - Country:US
Practice Address - Phone:415-345-9400
Practice Address - Fax:415-345-8049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG026584207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA33162Medicare UPIN
CA00C265840Medicare ID - Type Unspecified