Healthcare Provider Details

I. General information

NPI: 1043245640
Provider Name (Legal Business Name): PETER CHARLES GALIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL PLAZA #214,365,530,420,120
LOS ANGELES CA
90095-3075
US

IV. Provider business mailing address

5767 W. CENTURY BLVD #400
LOS ANGLES CA
90045-5655
US

V. Phone/Fax

Practice location:
  • Phone: 310-458-2381
  • Fax: 310-260-2963
Mailing address:
  • Phone: 310-828-7172
  • Fax: 310-394-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG74741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: