Healthcare Provider Details

I. General information

NPI: 1083658223
Provider Name (Legal Business Name): GALEN INPATIENT PHYSICIAN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 LONE TREE WAY
ANTIOCH CA
94509
US

IV. Provider business mailing address

2100 POWELL STREET STE 920
EMERYVILLE CA
94608
US

V. Phone/Fax

Practice location:
  • Phone: 925-779-7200
  • Fax:
Mailing address:
  • Phone: 510-350-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LESLIE ANGLADA
Title or Position: M.D
Credential:
Phone: 510-350-2681