NPIMap

Organization Active NPI

Glen D. Jarus, M.D., Inc.

  • Retina Specialist (Ophthalmology) Physician
  • Whittier, CA
National Provider Identifier
1124171657
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
G36924 Issued in CA
Legal business name
GLEN D. JARUS, M.D., INC.
Practice address
6319 Greenleaf Ave
Whittier, CA 90601-3536
Phone
(562) 945-2468
Fax
(562) 945-8804
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Authorized official

Name
Dr. Glen Daniel Jarus, MD
Title
President
Phone
(562) 945-2468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X G36924 CA Primary

Addresses

Primary practice location

6319 Greenleaf Ave
Whittier, CA 90601-3536

Mailing address

6319 Greenleaf Ave
Whittier, CA 90601-3536
Phone (562) 945-2468

Other identifiers 1

IdentifierTypeStateIssuer
GR0053741MedicaidCA

National Provider Directory

National Provider Directory

Locations

1401 N Tustin Ave
Ste 220
Santa Ana, CA 92705
Phone (714) 543-6020

1135 S Sunset Ave
Ste 407
West Covina, CA 91790
Phone (562) 945-2468

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1124171657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6319 GREENLEAF AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906013536",
            "telephone_number": "562-945-2468",
            "fax_number": "562-945-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6319 GREENLEAF AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906013536",
            "telephone_number": "562-945-2468",
            "fax_number": "562-945-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN D. JARUS, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "JARUS",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-945-2468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "G36924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0053741",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.