Healthcare Provider Details

I. General information

NPI: 1740698828
Provider Name (Legal Business Name): VICTOR GALDOS RRT,CRT.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 N SARATOGA ST
TEMPE AZ
85281
US

IV. Provider business mailing address

2637 N SARATOGA ST
TEMPE AZ
85281
US

V. Phone/Fax

Practice location:
  • Phone: 623-237-1922
  • Fax:
Mailing address:
  • Phone: 623-237-1922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number007445
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: