Active NPI
Glenn A Huettner, MD
- Diagnostic Radiology Physician
- Torrance, CA
National Provider Identifier
1114900693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G47711
- Practice address
- 4101 Torrance Blvd
Torrance, CA 90503-4607 - Phone
- (310) 303-5750
- Fax
- (310) 303-5709
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G47711 | CA | Primary |
Addresses
Primary practice location
4101 Torrance Blvd
Torrance, CA 90503-4607
Mailing address
Dept la 21552
Pasadena, CA 91185-1552
Phone (949) 263-8620
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G477110 | Other | BLUE SHIELD | |
| 00G477110 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G47711 | CA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centinela Radiology Medical Group | Diagnostic Radiology | Past | Accepting new patients |
| Cedars-Sinai Medical Care Foundation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Los Angeles, CA
- NPI 1316984388
-
- Diagnostic Radiology Physician
- Inglewood, CA
- NPI 1861475352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367280000000",
"number": "1114900693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT LA 21552",
"city": "PASADENA",
"state": "CA",
"postal_code": "911851552",
"telephone_number": "949-263-8620",
"fax_number": "949-263-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 TORRANCE BLVD",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905034607",
"telephone_number": "310-303-5750",
"fax_number": "310-303-5709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUETTNER",
"first_name": "GLENN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2013-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G47711",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G477110",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G477110",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.