Glen Isamu Komatsu, MD - Medicare Pain Medicine in Rancho Palos Verdes, CA

Glen Isamu Komatsu, MD is a medicare enrolled "Pain Medicine - Pain Medicine" physician in Rancho Palos Verdes, California. His current practice location is 6069 Woodfern Dr, Rancho Palos Verdes, California. You can reach out to his office (for appointments etc.) via phone at (310) 375-4585.

Glen Isamu Komatsu is licensed to practice in California (license number A35086) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114939394.

Contact Information

Glen Isamu Komatsu, MD
6069 Woodfern Dr,
Rancho Palos Verdes, CA 90275-2263
(310) 375-4585
(310) 375-1735



Physician's Profile

Full NameGlen Isamu Komatsu
GenderMale
SpecialityPain Medicine - Pain Medicine
Location6069 Woodfern Dr, Rancho Palos Verdes, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114939394
  • Provider Enumeration Date: 08/13/2006
  • Last Update Date: 09/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8820060361
  • Enrollment ID: I20060119000349

Medical Identifiers

Medical identifiers for Glen Isamu Komatsu such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114939394NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208VP0000XPain Medicine - Pain Medicine A35086 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Glen Isamu Komatsu allows following entities to bill medicare on his behalf.
Entity NameProvidence Trinitycare Hospice
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366034423
PECOS PAC ID: 1153357983
Enrollment ID: O20050713000622

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glen Isamu Komatsu is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Glen Isamu Komatsu, MD
6069 Woodfern Dr,
Rancho Palos Verdes, CA 90275-2263

Ph: (310) 375-4585
Glen Isamu Komatsu, MD
6069 Woodfern Dr,
Rancho Palos Verdes, CA 90275-2263

Ph: (310) 375-4585

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Pain Medicine Doctors in Rancho Palos Verdes, CA


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