NPI 1053614404

Selena Anne Lantry, M.D., INC

Organisation Specialist Glendale, CA

Practice location

Address: 1505 Wilson Ter STE 130, Glendale, CA 91206-4074
Phone: (818) 247-2164

Authorised official

Name: Selena Anne Lantry
Title: President
Phone: (818) 247-2164

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence G55968 (CA)

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Registry record

NPI: 1053614404
Entity type: Organization
NPI issued: 7 Dec 2010
Record last updated: 7 Dec 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.