Provider Demographics
NPI:1891108270
Name:GLAUBIGER, SUSAN (PA-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:GLAUBIGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38690 STIVERS ST
Mailing Address - Street 2:#A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5279
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:38690 STIVERS ST
Practice Address - Street 2:#A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5279
Practice Address - Country:US
Practice Address - Phone:510-248-1040
Practice Address - Fax:510-797-7426
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51901363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical