Healthcare Provider Details

I. General information

NPI: 1114536943
Provider Name (Legal Business Name): EILIER ALARCON GALAN MD,PA,RDMS,RPT,RMA.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5008 W NORTHERN AVE STE 14
GLENDALE AZ
85301-1570
US

IV. Provider business mailing address

12329 N 121ST AVE
EL MIRAGE AZ
85335-3349
US

V. Phone/Fax

Practice location:
  • Phone: 602-699-7902
  • Fax: 623-289-7898
Mailing address:
  • Phone: 602-544-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2074-PA
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTPPA687
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberTPPA687
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2074-PA
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number105453
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number105453
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number105453
License Number StateNULL
# 8
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number198878
License Number StateAZ
# 9
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number202010152365
License Number StateAZ
# 10
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number198878
License Number StateAZ
# 11
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number198878
License Number StateAZ
# 12
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number198878
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: