NPIMap

Organization Active NPI

Glendale Pediatrics, a Professional Corporation

  • Pediatrics Physician
  • Glendale, CA
National Provider Identifier
1720115660
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C39475 Issued in CA
Legal business name
GLENDALE PEDIATRICS, A PROFESSIONAL CORPORATION
Practice address
1530 E Chevy Chase Dr
Suite 101
Glendale, CA 91206-4163
Phone
(818) 246-7260
Fax
(818) 502-9247
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard Harlan Feuille Jr., M.D.NPI 1114015930
Title
President
Phone
(818) 246-7260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X C39475 CA Primary

Addresses

Primary practice location

1530 E Chevy Chase Dr
Suite 101
Glendale, CA 91206-4163

Mailing address

1530 E Chevy Chase Dr
Suite 101
Glendale, CA 91206-4163
Phone (818) 246-7260

National Provider Directory

National Provider Directory

Locations

1530 E Chevy Chase Dr
Ste 101
Glendale, CA 91206
Phone (818) 246-7260

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720115660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 E CHEVY CHASE DR",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064163",
            "telephone_number": "818-246-7260",
            "fax_number": "818-502-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E CHEVY CHASE DR",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064163",
            "telephone_number": "818-246-7260",
            "fax_number": "818-502-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE PEDIATRICS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FEUILLE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "HARLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-246-7260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C39475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.