Provider Demographics
NPI:1932349297
Name:LUTHER D GLENN MD INC
Entity Type:Organization
Organization Name:LUTHER D GLENN MD INC
Other - Org Name:RANCHO MIRAGE ONCOLOGY-HEMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUTHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-202-3800
Mailing Address - Street 1:35900 BOB HOPE DR
Mailing Address - Street 2:SUITE 175
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1766
Mailing Address - Country:US
Mailing Address - Phone:760-202-3800
Mailing Address - Fax:760-202-7799
Practice Address - Street 1:35900 BOB HOPE DR
Practice Address - Street 2:SUITE 175
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1766
Practice Address - Country:US
Practice Address - Phone:760-202-3800
Practice Address - Fax:760-202-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory