Provider Demographics
NPI:1538448949
Name:GLAPA, GARRETT G (NP)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:G
Last Name:GLAPA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11239 VENTURA BLVD
Mailing Address - Street 2:STE 213
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3167
Mailing Address - Country:US
Mailing Address - Phone:818-505-0152
Mailing Address - Fax:818-505-0398
Practice Address - Street 1:2806 TOWNSGATE RD
Practice Address - Street 2:SUITE B
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3064
Practice Address - Country:US
Practice Address - Phone:805-494-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20530363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFP381ZMedicare PIN