NPIMap

Organization Active NPI

Crystal Surgical Center

  • Internal Medicine Physician
  • Glendale, CA
National Provider Identifier
1720949597
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CRYSTAL SURGICAL CENTER
Practice address
350 Arden Ave Ste 102
Glendale, CA 91203-1110
Phone
(818) 906-4466
Fax
(818) 475-1785
NPI assigned
Nov 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
Mr. Gilbert Emile Faustina, MDNPI 1558303271
Title
Ceo
Phone
(818) 906-4466

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

350 Arden Ave Ste 102
Glendale, CA 91203-1110

Mailing address

350 Arden Ave Ste 102
Glendale, CA 91203-1110
Phone (818) 906-4466

National Provider Directory

National Provider Directory

Locations

350 Arden Ave
Ste 102
Glendale, CA 91203
Phone (818) 846-5428

Practitioners & affiliated clinicians

Practitioners 5

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": "1763596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1720949597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ARDEN AVE STE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031110",
            "telephone_number": "818-906-4466",
            "fax_number": "818-475-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ARDEN AVE STE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031110",
            "telephone_number": "818-906-4466",
            "fax_number": "818-475-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "FAUSTINA",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "EMILE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-906-4466",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 Nov 20, 2025; 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.