DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. GLENN JOSEPH PAYNE, CRT

Active Sole Proprietor

2278P1006X · ONTARIO, CA

Registration Details

NPI Number
1962735381
Provider Type
Individual
Gender
Male
NPI Issued
Sep 16, 2009 (16.63717758731 yrs)
Last Updated
Sep 16, 2009
Licenses
00018987 (CA)
00018987 (CA)
00018987 (CA)
00018987 (CA)
Sole Proprietor
Yes

Practice Information

Address
1110 E PHILADELPHIA ST
9207
ONTARIO, CA, 917614810
Browse CA providers · Browse ZIP 91761
Phone
9097815406
Primary Specialty
2278P1006X
2278P1006X
Additional Specialty
2278G1100X
Additional Specialty
2278P1004X
Additional Specialty
2278P1006X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.