Glen Park at Glendora

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GLEN PARK AT GLENDORA

Practice address

452 Sellers St
Glendora, CA 91741-3846

Phone

(626) 594-0152

NPI assigned

Nov 7, 2023

Last updated

Nov 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tillman Pink Jr.

Title

Ceo/President

Phone

(818) 590-9827

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1922872266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 S CENTRAL AVE # 202",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043957",
            "telephone_number": "818-296-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 SELLERS ST",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413846",
            "telephone_number": "626-594-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN PARK AT GLENDORA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "PINK",
        "authorized_official_first_name": "TILLMAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-590-9827",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maged Gindi, RPH
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• Erica Jane Gladney
• Glendora Anesthesia Associates LP
• Glendora Ca Endoscopy ASC LP (Glendora Digestive Disease Institute)
• Glendora Chiropractic Center
• Glendora Dermatologic and Cosmetic Surgery Center
• Glendora Family Counseling, a Professional Corporation (Glendora Counseling)

• Assisted Living Facility in Glendora, CA
• Providers in Glendora, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.