| Organization Name: | GLEN I KOMATSU M D A PROFESSIONAL CORPORATION |
| NPI Number: | 1073734778 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GLEN I KOMATSU (OWNER) |
| Mailing Address: | 4101 Torrance Blvd Palliative Care Torrance |
| State: | CA US |
| Postal Code: | 905034607 |
| Phone Number: | 3103036840 |
| Fax Number: | 3103035574 |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 10/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |