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Dr. Glenn Howard Perelson

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NPI Number Detailed Information

Provider Information:

Name: Dr. Glenn Howard Perelson
Gender: M
Provider License Number If Given: G63071

NPI Information:

NPI: 1972506970
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: PO BOX 606
Spring Valley, CA 91976
Phone Number: 6194603109
Fax Number:

Provider Business Practice Location Address:

Address: 740 BAY BLVD
Chula Vista, CA 91910
Phone Number: 6194986423
Fax Number:

Provider Taxonomy:

Primary: 207RC0000X
Secondary (if any):
State: CA

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