NPIMap

Organization Active NPI

Glass Beach Medical Services a Medical Corporation

  • Emergency Medicine Physician
  • San Ramon, CA
National Provider Identifier
1710336300
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
GLASS BEACH MEDICAL SERVICES A MEDICAL CORPORATION
Practice address
6001 Norris Canyon Rd
San Ramon, CA 94583-5400
Phone
(973) 251-1132
NPI assigned
Jun 6, 2016
Last updated
Mar 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Karen Vaughn
Title
Authorized Official
Phone
(404) 450-4684

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

6001 Norris Canyon Rd
San Ramon, CA 94583-5400

Mailing address

5565 Centerview Dr Ste 107
Raleigh, NC 27606-3563

Other practice location 1

1301 N Rose Dr
Placentia, CA 92870-3899
Phone (714) 993-2000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1710336300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 CENTERVIEW DR STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 NORRIS CANYON RD",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835400",
            "telephone_number": "973-251-1132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 N Rose Dr",
            "address_purpose": "LOCATION",
            "city": "Placentia",
            "state": "CA",
            "postal_code": "928703899",
            "country_code": "US",
            "telephone_number": "714-993-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GLASS BEACH MEDICAL SERVICES A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "404-450-4684"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.