Glendale Ophthalmology ASC LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

930000717 Issued in CA

Legal business name

GLENDALE OPHTHALMOLOGY ASC LP

Doing business as

Glendale Eye Surgery Center

Practice address

607 N Central Ave
Suite 103
Glendale, CA 91203-1804

Phone

(818) 956-1010

Fax

(818) 543-6083

NPI assigned

Feb 8, 2006

Last updated

Sep 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Phillip A Clendenin

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Glendale Eye Surgery Center Doing business as

Practitioners 1

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.

• Michael T Reid, CRNA

  • Certified Registered Nurse Anesthetist
  • Colton, CA
  • NPI 1104832039
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1225001423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 N CENTRAL AVE",
            "address_2": "SUITE 103",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031804",
            "telephone_number": "818-956-1010",
            "fax_number": "818-543-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 N CENTRAL AVE",
            "address_2": "SUITE 103",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031804",
            "telephone_number": "818-956-1010",
            "fax_number": "818-543-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE OPHTHALMOLOGY ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "930000717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05-C0001131",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glendale Eye Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Glendale Medical Gear
• Glendale Medical Imaging Associates Inc
• Glendale Multi-Specialty Surgery Center, LLC (Glendale Outpatient Surgery Center)
• Glendale Mutual Care Clinic
• Glendale Nephrology Services, LLC (Glendale Kidney Center)
• Glendale Optometric Center
• Glendale Optometry
• Glendale Orthopaedics Inc.
• Glendale Pain Medicine Associates Inc (Tri-Valley Spine and Pain Centers)
• Glendale Pathology Associates Medical Group of Glendale

• Ambulatory Surgical Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Ambulatory Surgical Clinic/Center 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.