MEDICARE: GALLONI ENTERPRISES MEDICAL CORPORATION

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	207X00000X	Orthopaedic Surgery Physician	A38436	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740339274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALLONI ENTERPRISES MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 5411
Second Line	:
City	:	NORCO
State	:	CA
Zip	:	92860-8014
Country	:	US
Telephone Number	:	323-271-4173
Fax Number	:	951-215-2620

Provider Business Practice Location Address
First Line	:	1127 WILSHIRE BLVD STE 408
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-3905
Country	:	US
Telephone Number	:	323-271-4173
Fax Number	:	951-215-2620

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LUIGI F GALLONI
Credential	:	M.D.
Telephone Number	:	323-271-4173

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	02/08/2022

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