Healthcare Provider Details

I. General information

NPI: 1750245742
Provider Name (Legal Business Name): MOANALOA CHRISTINA GALALA PEER SUPPORT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 E 6TH ST
LONG BEACH CA
90802-1402
US

IV. Provider business mailing address

15519 CRENSHAW BLVD
GARDENA CA
90249-4525
US

V. Phone/Fax

Practice location:
  • Phone: 562-435-7350
  • Fax:
Mailing address:
  • Phone: 310-679-9126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-WJDQHT
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: