OrganizationActive
Glendale Rejuvenation Medical Group
NPI 1073960407 · Obesity Medicine (Family Medicine) Physician · Wilmington, CA
Provider details
- NPI number
- 1073960407
- Entity type
- Organization
- Primary specialty
- Obesity Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Eddie Santiago, Manager(818) 610-9360
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Social Worker104100000X
Behavioral Health & Social Service Providers
- Nutrition Chiropractor111NN1001X
Chiropractic Providers
- Registered Dietitian133V00000X
Dietary & Nutritional Service Providers
- Allergy & Immunology Physician207K00000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- General Practice Physician208D00000X
Practice location
1703 N Avalon Blvd
Wilmington, CA 90744-1432
Phone: (310) 233-9355
Fax: (310) 233-2545
Approximate (ZIP-level) locationGet directions
Mailing address
1703 N Avalon Blvd
Wilmington, CA 90744-1432
Other names (DBA / former)
- Doing business as
- Glendale Rejuvenation Medical Group
- Doing business as
- Glendale Rejuvenation Medical Group
Registry dates
- Enumerated
- 2016-05-16
- Last updated
- 2021-12-21
- Certified
- 2021-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.