Healthcare Provider Details

I. General information

NPI: 1295951937
Provider Name (Legal Business Name): NEAL GALEN, D.O., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 WEST GLENDALE AVENUE SUITE #103
PHOENIX AZ
85021-6288
US

IV. Provider business mailing address

1728 WEST GLENDALE AVENUE SUITE #103
PHOENIX AZ
85021-6288
US

V. Phone/Fax

Practice location:
  • Phone: 602-246-4917
  • Fax: 602-246-1432
Mailing address:
  • Phone: 602-246-4917
  • Fax: 602-246-1432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1760
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number1760
License Number StateAZ

VIII. Authorized Official

Name: DR. NEAL GALEN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 602-246-4917