Glen I Komatsu M D a Professional Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

GLEN I KOMATSU M D A PROFESSIONAL CORPORATION

Practice address

4101 Torrance Blvd
Palliative Care
Torrance, CA 90503-4607

Phone

(310) 303-6840

Fax

(310) 303-5574

NPI assigned

May 1, 2007

Organization subpart

Yes

Parent organization

PROVIDENCE HEALTH AND SERVICESAs reported in NPPES

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

Authorized official

Name

Glen I Komatsu, MD

Title

Owner

Phone

(310) 375-4585

Specialties & licenses 1

Addresses

Part of

Providence Health System - Southern California

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Providence Health & Services

  • General Acute Care Hospital
  • North Hollywood, CA
  • NPI 1093056632
  NPPES parent name

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1073734778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6069 WOODFERN DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902752263",
            "telephone_number": "310-545-9713",
            "fax_number": "310-546-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TORRANCE BLVD",
            "address_2": "PALLIATIVE CARE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034607",
            "telephone_number": "310-303-6840",
            "fax_number": "310-303-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN I KOMATSU M D A PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH AND SERVICES",
        "enumeration_date": "2007-05-01",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "KOMATSU",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-375-4585",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaleah Elyse Glass
• Leah Suzanne Glavan, BSN RN CIS
• Robert N Glazer, MD
• Ryan Gleber, MD, BS
• Peter Gleiberman, M.D.
• Glenn a. Pasternack, M.D. & Tamar F. Singer, M.D., Inc.
• Glenn J. Huber, M.D., Inc.
• Richard A Glimp, MD
• Erica Glinsky, IBCLC
• Global Grace Medical Services Inc

• General Practice Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.