Provider Demographics
NPI:1700353828
Name:WESTERN ACUTE CARE PHYSICIANS, INC.
Entity Type:Organization
Organization Name:WESTERN ACUTE CARE PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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:949-307-6210
Mailing Address - Street 1:456 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1278
Mailing Address - Country:US
Mailing Address - Phone:949-307-6210
Mailing Address - Fax:
Practice Address - Street 1:9838 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3804
Practice Address - Country:US
Practice Address - Phone:562-306-5800
Practice Address - Fax:562-306-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center