Individual provider · Type 1 NPI

Glen Stephen Ellis, C.P.O.

Specialist · Castro Valley, CA

NPI number 1023156130 Active

Practice location

3553 Castro Valley Blvd, Suite B
Castro Valley, CA 94546-4400

Call (510) 537-1210 Map

Fax (510) 537-1082

Mailing address

2260 Jeffrey St
Livermore, CA 94550-6463

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

2 other providers at this address

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About NPI 1023156130

Glen Stephen Ellis, C.P.O.'s National Provider Identifier is 1023156130, issued on Feb 1, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Castro Valley, CA. The record was last updated on Jul 8, 2007.