The Labster

Specialty details in registry · Glendale, CA

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At a glance

1015 N Kenilworth Ave Unit B, Glendale, CA 91202-2822

NPPES record updated Mar 2, 2026. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

1015 N Kenilworth Ave Unit B
Glendale, CA 91202-2822
Professional details: NPI, taxonomy & registry record
NPI1124973516
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
261QV0200X
Enumeration date
Mar 2, 2026
Record updated
Mar 2, 2026
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

261QV0200X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1015 N Kenilworth Ave Unit B
Glendale, CA 91202-2822
Phone
(818) 482-6378
Mailing address
1015 N KENILWORTH AVE UNIT B

GLENDALE, CA 912022822
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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