Kevin Scott Glenn, D.C.,DABCO
Individual provider Active NPI Orthopedic Chiropractor · Diamond Bar, CA
NPI 1801811005 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1801811005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Chiropractor 111NX0800X
- License
- DC16390 (CA)
- Practice address
- 23341 Golden Springs Dr Ste 202
Diamond Bar, CA 91765-2054 - Phone
- (909) 860-0148
- Fax
- (909) 860-9348
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC16390 | CA | MD | Orthopedic Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Ekta Sharma MD MPH Inc | Past |
Accepting new patients | |
| Southern California University of Health Sciences | Past | Accepting new patients | |
| Amar Medical Group Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | DC16390 | CA | Yes |
Addresses
Primary practice location
23341 Golden Springs Dr Ste 202
Diamond Bar, CA 91765-2054
Mailing address
23341 Golden Springs Dr Ste 202
Diamond Bar, CA 91765-2054
Phone (909) 860-0148
Other providers in Diamond Bar, CA
- Patricia Danielah Germon
- Kunal Ghosh
- Sangram Gill
- Alyssa M Givehand
- Glenn Chang DDS Inc
- Global Mother Care Group Inc
- Golden Springs Pharmacy Inc.
- Gong Pharmacist Professional Corporation
- Veronica Angelina Gonzalez
- Amy Melissa Goodson
All providers in Diamond Bar, CA · Orthopedic Chiropractor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.