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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 |
