MEDICARE: ANGELA GALAVIZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	9951	CA

General Provider Information

NPI Number	:	1174143457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA GALAVIZ

Provider Business Mailing Address
First Line	:	11710 NORINO DR
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-2203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12417 PHILADELPHIA ST
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-3933
Country	:	US
Telephone Number	:	562-698-8121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2020
Last Update Date	:	04/16/2020

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Directions to “ ANGELA GALAVIZ ” Practice Location

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