Healthcare Provider Details

I. General information

NPI: 1730621079
Provider Name (Legal Business Name): ELSIE GALANO DAVID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 IMPERIAL HWY
DOWNEY CA
90242-3456
US

IV. Provider business mailing address

7601 IMPERIAL HWY
DOWNEY CA
90242-3456
US

V. Phone/Fax

Practice location:
  • Phone: 562-385-8005
  • Fax: 562-385-6383
Mailing address:
  • Phone: 562-385-8005
  • Fax: 562-385-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number812508
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: