North Glendale Regenerative Medicine Clinic PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTH GLENDALE REGENERATIVE MEDICINE CLINIC PLLC

Practice address

18301 N 79TH Ave Ste F168
Glendale, AZ 85308-6045

Phone

(623) 544-9090

NPI assigned

Jan 2, 2024

Last updated

Jan 2, 2024By 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

Seth Clark, DPMNPI 1669811915

Title

Owner

Phone

(801) 448-4841

Specialties & licenses 1

Addresses

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.

• Seth Clark, DPM

  • Podiatrist
  • Phoenix, AZ
  • NPI 1669811915
  Authorized official Same address or phone

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1275302291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE STE F168",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086045",
            "telephone_number": "623-544-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE STE F168",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086045",
            "telephone_number": "623-544-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GLENDALE REGENERATIVE MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-448-4841",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Mendoza Noriega, FNP-C
• Rudy Noriega, PAC
• Brandi Norman
• Elizabeth Norman
• North Family Medicine LTD
• North Glendale Regenerative Medicine PLLC
• North Valley Ear, Nose & Throat Associates, P.C
• North Valley Emergency Specialists
• North Valley Family Medicine PC
• North Valley Surgical Associates, PC (Arizona Preferred Surgeons)

• Ambulatory Surgical Clinic/Center in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.