Individual provider Active NPI

Peter Glickman, M.D.

  • Ophthalmology Physician
  • Placentia, CA
National Provider Identifier
1851644587
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G35832 Issued in CA
Practice address
1050 E Yorba Linda Blvd.
Suite 205
Placentia, CA 92870
Phone
(714) 792-0182
Fax
(714) 792-0182
NPI assigned
Oct 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G35832 CA Primary

Addresses

Primary practice location

1050 E Yorba Linda Blvd.
Suite 205
Placentia, CA 92870

Mailing address

1050 E. Yorba Linda Blvd.
Suite 205
Placentia, CA 92870
Phone (714) 792-0182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G35832CAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1851644587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E. YORBA LINDA BLVD.",
            "address_2": "SUITE 205",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "92870",
            "telephone_number": "714-792-0182",
            "fax_number": "714-792-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E YORBA LINDA BLVD.",
            "address_2": "SUITE 205",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "92870",
            "telephone_number": "714-792-0182",
            "fax_number": "714-792-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G35832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.