Glenn Cook, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G63727 Issued in CA

Practice address

7877 Parkway Dr
Suite 100
La Mesa, CA 91942-2000

Phone

(619) 460-3711

Fax

(619) 460-2184

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Alvarado Eye Associates Med Clinic Inc

  • Multi-Specialty Clinic/Center
  • La Mesa, CA
  • NPI 1619973591

  CA, Ophthalmology

  Medicare reassignment NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1013078427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7877 PARKWAY DR",
            "address_2": "SUITE 100",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422000",
            "telephone_number": "619-460-3711",
            "fax_number": "619-460-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7877 PARKWAY DR",
            "address_2": "SUITE 100",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422000",
            "telephone_number": "619-460-3711",
            "fax_number": "619-460-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "GLENN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G63727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN PROVIDER NUMBER",
            "identifier": "0802380001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G637271",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORONADO OFFICE NORIDIAN",
            "identifier": "0802380003",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert C Conlin, DC
• Megan Conlon
• Chelsea Eva Connell, PMHNP - BC
• Jack Connolly
• Cierra Marai Conwright, SLPA
• Julia Herta Ione Cook
• Ora Cadesia Cooley
• William Morris Coombs III, DSW, ACSW
• Karen Cooper, LMFT
• Carlye Ann Corcoran, MD

• All providers in La Mesa, CA
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.