GLENDALE REJUVENATION MEDICAL GROUP (NPI# 1073960407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073960407 |
| Entity Type | Organization |
| Organization Name | GLENDALE REJUVENATION MEDICAL GROUP |
| Other Organization Name | GLENDALE REJUVENATION MEDICAL GROUP |
| Practice Address |
230 N Maryland Ave Suite 110 Glendale CA 91206-4261 |
| Practice Telephone | 8185510464 |
| Practice Fax Number | 8185510466 |
| Mailing Telephone | 8185510464 |
| Mailing Fax Number | 8185510466 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |
| Authorized Official Name | MR. EDDIE SANTIAGO (MANAGER) |
| Authorized Official Telephone | 8186109360 |
| Authorized Official Credential | MANAGER |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 111NN1001X |
Chiropractor Specialization: Nutrition |
Chiropractic Providers | ||
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| N | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207QB0002X |
Family Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Glendale Rejuvenation Medical Group | Doing Business As Name - Organization |
| Street Address |
230 N MARYLAND AVE SUITE 110 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91206-4261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639260466 | Natalie Bergquist Hogue | Dentist | 230 N Maryland Ave, Suite 102, Glendale, CA 91206-4261 | 2006-09-27 |
| 1104254374 | V A Halajian Dental Corporation | Dentist | 230 N Maryland Ave, Suite 206, Glendale, CA 91206-4261 | 2013-10-24 |
| 1639430994 | Arthur Sarkisian | Social Worker | 230 N Maryland Ave, Suite 209, Glendale, CA 91206-4261 | 2012-06-04 |
| 1407130768 | Nansi Manokian | Counselor | 230 N Maryland Ave, Suite 303, Glendale, CA 91206-4261 | 2011-10-05 |
| 1841597028 | Elsa Garcia-sanda | Social Worker | 230 N Maryland Ave, Suite 103, Glendale, CA 91206-4261 | 2011-02-23 |
| 1083922827 | Matthew Nabi Moadel | Dentist | 230 N Maryland Ave, #206, Glendale, CA 91206-4261 | 2010-09-15 |
| 1003047341 | Lyla A. Gazarian-boustani | Dentist | 230 N Maryland Ave, Suite 206, Glendale, CA 91206-4261 | 2009-08-04 |
| 1972768158 | Glendale Mutual Care Clinic | Clinic/Center | 230 N Maryland Ave, Suite 105, Glendale, CA 91206-4261 | 2008-07-27 |
| 1992973812 | Amandeep Singh | Dentist | 230 N Maryland Ave, Ste. 205, Glendale, CA 91206-4261 | 2008-02-13 |
| 1902086648 | Claire Frances Hieber | Social Worker | 230 N Maryland Ave, Ste 303, Glendale, CA 91206-4281 | 2007-11-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922611003 | Skyla L Bergin | Behavior Technician | 741 Glenvia St., Suite 200, Glendale, CA 91206 | 2020-08-28 |
| 1861017303 | Scm Nutrition Diet Inc | Dietitian, Registered | 2437 Bywood Drive, Glendale, CA 91206 | 2020-06-10 |
| 1336761295 | Glendale Whole Health | Family Medicine | 230 N Maryland Aave #110, Glendale, CA 91206 | 2020-05-14 |
| 1467010801 | Rebecca Bautista | Counselor | 223 North Jackson Street, Glendale, CA 91206 | 2019-05-31 |
| 1689132920 | M4l Transport Inc | Non-emergency Medical Transport (VAN) | 336 N Louise St #4d, Glendale, CA 91206 | 2019-03-05 |
| 1376042705 | Eileen Wong, Md Inc. | Physical Medicine & Rehabilitation | 2664 E Glenoaks Blvd, Glendale, CA 91206 | 2018-02-12 |
| 1629507900 | Aleksan Chakhoyan | Registered Nurse | 501 N. Glendale Ave., Glendale, CA 91206 | 2017-06-08 |
| 1851793343 | Sevak Olmessekian | Pharmacist | 230 N. Maryland Ave., Suite 307, Glendale, CA 91206 | 2014-09-16 |
| 1558762575 | Zyanya Mendoza | Clinical Neuropsychologist | 1560 E Chevy Chase Dr Ste 140, Glendale, CA 91206 | 2014-09-09 |
| 1629488358 | Nina Behdin | Surgery | 1560 E Chevy Chase Dr Ste 430, Glendale, CA 91206 | 2014-05-02 |
| Find all providers in zip 91206 | ||||
| Taxonomy Code | 207QB0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Obesity Medicine |
| A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. |
| Notes: Source: American Board of Obesity Medicine, www.abom.org [7/1/2015: title and definition modified] Additional Resource: American Society of Bariatric Physicians, www.asbp.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376925602 | Glendale Weightloss LLC | Family Medicine | 5310 W Thunderbird Rd, Ste 308, Glendale, AZ 85306-4706 | 2015-06-23 |
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| 1962045047 | Phyllis Schorr | Family Medicine | 2209 Coffee Rd Ste C, Modesto, CA 95355-2360 | 2019-10-22 |
| 1821512963 | Robert A. Spack | Family Medicine | 5129 Ming Avenue, Bakersfield, CA 93309 | 2017-07-31 |
| 1952673642 | Don Simon Jensen | Family Medicine | 21016 Victory Blvd, Woodland Hills, CA 91367-2610 | 2012-01-27 |
| 1578833059 | Jsmd PC | Family Medicine | 350 Lorton Avenue, Burlingame, CA 94010-4104 | 2011-12-30 |
| 1932429636 | Arthur Donald Hux | Family Medicine | 340 Raleys Towne Center, Rohnert Park, CA 94928-1304 | 2010-06-03 |
| 1134309446 | Pearson Medical Clinic, Inc. | Family Medicine | 394 Pearson Dr, Porterville, CA 93257-3368 | 2007-11-05 |
| 1225226012 | Asif M Azimi | Family Medicine | 16705 Hawthorne Blvd, Lawndale, CA 90260-3244 | 2007-10-05 |
| 1194896308 | Bariatric Weight Management Systems A Medical Group Inc | Family Medicine | 3300 Irvine Ave Ste 110, Newport Beach, CA 92660 | 2006-11-10 |
| 1750848941 | Prestige Bariatric and Surgical Specialists Inc | Family Medicine | 7551 Timberlake Way Ste 230, Sacramento, CA 95823-5422 | 2019-02-25 |
| 1265926000 | Quest Premier Medical Group A Professional Medical Corporation | Family Medicine | 1630 E Gonzales Rd, Oxnard, CA 93036-3700 | 2018-06-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.