Glendale Retina Associates Medical Group Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

GLENDALE RETINA ASSOCIATES MEDICAL GROUP INC.

Practice address

1025 N Brand Blvd
Suite 200
Glendale, CA 91202-2950

Phone

(818) 230-2140

Fax

(818) 230-2148

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Sanjay Logani, MDNPI 1124131958

Title

President

Phone

(818) 886-6700

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sanjay Logani, MD

  • Retina Specialist (Ophthalmology) Physician
  • Reseda, CA
  • NPI 1124131958
  NPD (past) Authorized official

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1609989425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N BRAND BLVD",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022950",
            "telephone_number": "818-230-2140",
            "fax_number": "818-230-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N BRAND BLVD",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022950",
            "telephone_number": "818-230-2140",
            "fax_number": "818-230-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE RETINA ASSOCIATES MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "LOGANI",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-886-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0104990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Glendale Unified School District
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• Glendale West Drug Co Inc

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

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