Healthcare Provider Details

I. General information

NPI: 1528383510
Provider Name (Legal Business Name): GALLOWAY WELL BUILDING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SANTA FE DR
ENCINITAS CA
92024-5132
US

IV. Provider business mailing address

303 SANTA FE DR
ENCINITAS CA
92024-5132
US

V. Phone/Fax

Practice location:
  • Phone: 760-635-9185
  • Fax: 760-942-1359
Mailing address:
  • Phone: 760-635-9185
  • Fax: 760-942-1359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberG083314
License Number StateCA

VIII. Authorized Official

Name: DR. GIL Q. GALLOWAY
Title or Position: OWNER
Credential: M.D.
Phone: 760-635-9185