Healthcare Provider Details

I. General information

NPI: 1265151120
Provider Name (Legal Business Name): GEORGE PATRICK GALANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 08/24/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 N BEDFORD DR STE 100
BEVERLY HILLS CA
90210-4308
US

IV. Provider business mailing address

9618 NEVADA AVE
CHATSWORTH CA
91311-4036
US

V. Phone/Fax

Practice location:
  • Phone: 424-355-0116
  • Fax:
Mailing address:
  • Phone: 818-929-4103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021904
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: