OrganizationGlendale Physicians AllianceContractorOther Service ProvidersPractice Address955 Overland Ct Fl 2, San Dimas, CA 91773-1718(909) 971-6715PECOS EnrollmentBased on the most recent information from CMS, provider Glendale Physicians Alliance does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1538283015Provider TypeOrganizationFull NameGlendale Physicians AllianceSubpartNoEnumeration Date3/19/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address955 Overland Ct Fl 2, San Dimas, CA 91773-1718Phone(909) 971-6715Fax(909) 971-6765Mailing LocationMailing Address955 Overland Ct Fl 2, San Dimas, CA 91773-1718Phone(909) 971-6715Fax(909) 971-6765Authorized OfficialNameNolasco, Ricardo (Network Associate)Phone(909) 971-6715Provider TaxonomiesCodeDescriptionLicenseCode171W00000XPrimaryDescriptionContractorOther Service ProvidersLicenseUnlisted Issuer