Individual provider Active NPI

Glenn Kazuo Morinishi, M.D.

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1871648121
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G65039 Issued in CA
Practice address
710 N Euclid St Ste 101
Anaheim, CA 92801-4132
Phone
(714) 772-1030
Fax
(714) 772-1758
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G65039 CA Primary

Addresses

Primary practice location

710 N Euclid St Ste 101
Anaheim, CA 92801-4132

Mailing address

710 N Euclid St Ste 400
Anaheim, CA 92801-4122
Phone (714) 517-2100

Other identifiers 1

IdentifierTypeStateIssuer
1750436473OtherCANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000957 CA Practitioner - Family Practice 3173781507 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

710 N Euclid St
Suite 101
Anaheim, CA 92801-4132
Phone (714) 517-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G65039CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Ipa Family Medicine Current Accepting new patients
Primary and Multi Specialty Clinics of Anaheim Inc CurrentSince Jul 1, 2018 Accepting new patients
Amg, a Professional Medical Corporation Family Medicine CurrentSince Aug 22, 2025 Accepting new patients
Primary and Multi Specialty Clinics of Anaheim Inc Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients

Locations

925 S Garfield Ave
Alhambra, CA 91801
Phone (626) 300-8388

710 N Euclid St
Ste 101
Anaheim, CA 92801
Phone (714) 517-2000

710 N Euclid St
Ste 400
Anaheim, CA 92801
Phone (714) 517-2000

801 N Tustin Ave
Ste 602
Santa Ana, CA 92705
Phone (714) 245-2417

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: glennmorinishi@ngmai.allscriptsdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1871648121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N EUCLID ST STE 400",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014122",
            "telephone_number": "714-517-2100",
            "fax_number": "714-300-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N EUCLID ST STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014132",
            "telephone_number": "714-772-1030",
            "fax_number": "714-772-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORINISHI",
        "first_name": "GLENN",
        "middle_name": "KAZUO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G65039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750436473",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.