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1376564948
GLENN ERIC MATHISEN
LOS ANGELES, CA
NPI
1376564948
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RI0200X Internal Medicine, Infectious Disease
(Licence: CA G44551)
Enumeration Date
2006-07-21
Last Update Date
2010-07-13
Business Address
-- GLENN ERIC MATHISEN md
200 MEDICAL PLAZA #365,420,520,120
LOS ANGELES, CA 90095
Phone number: 818-364-3205
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Mailing Address
-- GLENN ERIC MATHISEN md
5767 W CENTURY BLVD SUITE 200
LOS ANGELES, CA 90045-5632
Phone number: 818-364-3205
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