Active NPI
Glenoaks Urgent Care Medical Group, Inc.
- Family Medicine Physician
- Glendale, CA
National Provider Identifier
1013097120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A97912
- Legal business name
- GLENOAKS URGENT CARE MEDICAL GROUP, INC.
- Practice address
- 1100 W Glenoaks Blvd
Glendale, CA 91202-2606 - Phone
- (818) 242-3333
- Fax
- (818) 546-1056
- NPI assigned
- Oct 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Peter J Parker, MD
- Title
- President
- Phone
- (818) 546-2626
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A97912 | CA | Primary |
| Internal Medicine Physician | 207R00000X | A92103 | CA | |
| General Practice Physician | 208D00000X | A52178 | CA | |
| Podiatrist | 213E00000X | E4649 | CA |
Addresses
Primary practice location
1100 W Glenoaks Blvd
Glendale, CA 91202-2606
Mailing address
PO Box 5068
Glendale, CA 91221-2068
Phone (310) 276-4715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AW872B | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D1068384 | Glenoaks Urgent Care Medical Group, Inc | Certificate of waiver | May 8, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Glenoaks Urgent Care Medical Group | Heat & Cold Applications|Canes and/or Crutches|Walkers|Nebulizer Equipment and/or Supplies|Oxygen Equipment and/or Supplies | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
1100 W Glenoaks Blvd
Glendale, CA 91202
Phone (818) 242-3333
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Burbank, CA
- NPI 1811151681
-
- Surgery Physician
- Pinole, CA
- NPI 1588711709
-
- General Practice Physician
- Glendale, CA
- NPI 1922589670
-
- Family Medicine Physician
- Glendale, CA
- NPI 1336303718
-
- Addiction Medicine (Family Medicine) Physician
- Los Angeles, CA
- NPI 1659394633
General Practice
-
- Foot & Ankle Surgery Podiatrist
- Athens, GA
- NPI 1194701839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652745600000",
"number": "1013097120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5068",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912212068",
"telephone_number": "310-276-4715",
"fax_number": "310-276-4634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W GLENOAKS BLVD",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912022606",
"telephone_number": "818-242-3333",
"fax_number": "818-546-1056"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GLENOAKS URGENT CARE MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-16",
"last_updated": "2022-05-17",
"certification_date": "2022-05-17",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "PETER",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "818-546-2626",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "A97912",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "A92103",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": "CA",
"license": "A52178",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "CA",
"license": "E4649",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AW872B",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.