Glenn Stewart Katz, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

G035304 Issued in CA

Practice address

3553 Camino Mira Costa
Suite D
San Clemente, CA 92672-3512

Phone

(949) 661-8014

NPI assigned

Sep 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336230267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 CAMINO MIRA COSTA",
            "address_2": "SUITE D",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723512",
            "telephone_number": "949-661-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3553 CAMINO MIRA COSTA",
            "address_2": "SUITE D",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723512",
            "telephone_number": "949-661-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "GLENN",
        "middle_name": "STEWART",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "G035304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajesh Kadakia, MD
• Yuna Kagawa, RBT
• Yuri Kang, PHARMD
• Nick J Karahalios, MD
• Elizabeth Layne Katiarelas, PTA
• Sarah Kavlich, RD, CLEC
• Jensen Satoshi Kaya, DPT, PT
• Michael Murray Kaye
• Jennifer L Keenen, MA, AMFT
• D. Francesca Kelly, LMFT

• Pediatric Adolescent Medicine Physician in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.