Healthcare Provider Details

I. General information

NPI: 1871057687
Provider Name (Legal Business Name): JUSTIN GALVIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3477 S MERCY RD STE 208
GILBERT AZ
85297-0448
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-6880
  • Fax: 480-728-6281
Mailing address:
  • Phone: 602-406-4786
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number81191
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: