Healthcare Provider Details
I. General information
NPI: 1558042358
Provider Name (Legal Business Name): GALEN INPATIENT PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2023
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
975 S FAIRMONT AVE
LODI CA
95240-5118
US
IV. Provider business mailing address
2100 POWELL ST STE 400
EMERYVILLE CA
94608-1872
US
V. Phone/Fax
- Phone: 209-334-3411
- Fax:
- Phone: 510-350-2600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
BIRDSALL
Title or Position: CHIEF OPERATIONS OFFICER & VP
Credential: MD
Phone: 510-350-2600