Basic Information
Provider Information
NPI: 1962568964
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GLOR
FirstName: DANIEL
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE MEDICARE ENROLLMENT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 700 2ND ST NE
Address2: KAISER PERMANENTE CAPITOL HILL MEDICAL CENTER
City: WASHINGTON
State: DC
PostalCode: 200028100
CountryCode: US
TelephoneNumber: 2023463757
FaxNumber: 2023463751
Other Information
ProviderEnumerationDate: 12/28/2006
LastUpdateDate: 06/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XD28360MDN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400X0101043038VAN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400XMD17271DCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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