Healthcare Provider Details

I. General information

NPI: 1295592095
Provider Name (Legal Business Name): MR. RICHARD GLEN ENRIQUEZ GALOPE SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2228 BRUNDAGE LN
BAKERSFIELD CA
93304-2704
US

IV. Provider business mailing address

2228 BRUNDAGE LN
BAKERSFIELD CA
93304-2704
US

V. Phone/Fax

Practice location:
  • Phone: 844-748-8387
  • Fax:
Mailing address:
  • Phone: 844-748-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: