Glory Cabanilla Tancinco, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C50519 Issued in CA

Practice address

6245 De Longpre Ave
Los Angeles, CA 90028-8253

Phone

(234) 622-2713

NPI assigned

Apr 20, 2007

Last updated

Oct 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• WK MD Medical Group Inc

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1154802346
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1003033754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60790",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911166790",
            "fax_number": "213-413-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 DE LONGPRE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900288253",
            "telephone_number": "234-622-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANCINCO",
        "first_name": "GLORY",
        "middle_name": "CABANILLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "C50519",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C50519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuki R. Tanaka, SP
• Marsha Sally Ortaleza Tanare, FNP-C
• Lea Marie Tanasale, RN
• Thomas S Tanbonliong, D.D.S.
• Ethan Tanchoco, MD
• Pablito A Tancinco
• Michelle Tancio, OTR
• Maria Carmela Nosce Tandoc, SLPA
• Barton Tanenbaum, MD
• Carrie Tanenbaum, L. AC.

• Anesthesiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.