Healthcare Provider Details

I. General information

NPI: 1033240650
Provider Name (Legal Business Name): LUIS A. GALDAMEZ, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6831 SEVILLE AVE
HUNTINGTON PARK CA
90255-4805
US

IV. Provider business mailing address

6831 SEVILLE AVE
HUNTINGTON PARK CA
90255-4805
US

V. Phone/Fax

Practice location:
  • Phone: 323-581-8234
  • Fax: 323-581-0393
Mailing address:
  • Phone: 323-581-8234
  • Fax: 323-581-0393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA61918
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA048644
License Number StateCA

VIII. Authorized Official

Name: CORINA AYERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 323-581-8234