Provider Demographics
NPI:1548654973
Name:GLENX CARE INC
Entity type:Organization
Organization Name:GLENX CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADYSLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTSUL
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:818-561-4664
Mailing Address - Street 1:1915 W GLENOAKS BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1541
Mailing Address - Country:US
Mailing Address - Phone:818-561-4664
Mailing Address - Fax:818-561-4910
Practice Address - Street 1:1915 W GLENOAKS BLVD
Practice Address - Street 2:STE 101
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1541
Practice Address - Country:US
Practice Address - Phone:818-561-4664
Practice Address - Fax:818-561-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty