Healthcare Provider Details

I. General information

NPI: 1033100045
Provider Name (Legal Business Name): DONNA M GALLIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8361 W 3RD ST SUITE 1017
LOS ANGELES CA
90048-4312
US

IV. Provider business mailing address

17176 AVENIDA DE SANTA YNEZ
PACIFIC PALISADES CA
90272-2133
US

V. Phone/Fax

Practice location:
  • Phone: 310-289-5901
  • Fax: 310-289-5917
Mailing address:
  • Phone: 310-289-5901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG80598
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberG80598
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD2099
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number65276
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG80598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: