Glendale Rejuvenation Medical Group

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

GLENDALE REJUVENATION MEDICAL GROUP

Practice address

1703 N Avalon Blvd
Wilmington, CA 90744-1432

Phone

(818) 518-5980

NPI assigned

Dec 21, 2021

Organization subpart

No

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

Authorized official

Name

Jeffrey Feinberg

Title

Administrator

Phone

(818) 430-6312

Specialties & licenses 1

Addresses

Tax ID family

Glendale Rejuvenation Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Glendale Rejuvenation Medical Group

  • Obesity Medicine (Family Medicine) Physician
  • Wilmington, CA
  • NPI 1073960407
  NPD tax ID

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1457011256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7230 MEDICAL CENTER DR STE 405",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071940",
            "telephone_number": "818-518-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907441432",
            "telephone_number": "818-518-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE REJUVENATION MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-21",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "FEINBERG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-430-6312"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexia A Gil, LVN
• Joanne Giron
• Suzitte Daneen Giron
• Alexandra Gjersvold
• Glendale Rejuvenation Medical Group
• Global Medical Clinic
• Karla Jennifer Gomez, DMD
• Rocio Gomez, LVN
• Samuel Gonzalez
• Celia Alejandria Goze, RDA

• Non-Pharmacy Dispensing Site in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.