Glen-White Urological Medical Group Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

GLEN-WHITE UROLOGICAL MEDICAL GROUP INC

Practice address

1560 East Chevy Chase Dr
Suite 325
Glendale, CA 91206

Phone

(818) 242-1144

Fax

(818) 242-6948

NPI assigned

May 5, 2006

Last updated

Oct 31, 2017By 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

Sze-Ching Lee, MD

Title

President

Phone

(818) 242-1144

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Glen-White Urological Medical Group Inc

  • Urology Physician
  • Glendale, CA
  • NPI 1659556835

  O20050517001051

  Same enrollment

Locations

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1508814138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 EAST CHEVY CHASE DR",
            "address_2": "SUITE 325",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-242-1144",
            "fax_number": "818-242-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 EAST CHEVY CHASE DR",
            "address_2": "SUITE 325",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-242-1144",
            "fax_number": "818-242-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN-WHITE UROLOGICAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SZE-CHING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-242-1144",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065130",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9410927",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065131",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camber Spring Gleim, NBC-HWC
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• Glen Park East
• Glen-Park West Retirement Community, Inc
• Glen-White Urological Medical Group Inc
• Glenburb Home Health Inc
• Glenburb Hospice Inc
• Glendale Adhc Center Inc.
• Glendale Adventist Emergency Physicians Incorporated

• Urology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.