Healthcare Provider Details
I. General information
NPI: 1164992384
Provider Name (Legal Business Name): GALEN INPATIENT PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2018
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15891 LOS GATOS ALMADEN RD
LOS GATOS CA
95032-3742
US
IV. Provider business mailing address
2100 POWELL ST STE 900
EMERYVILLE CA
94608-1844
US
V. Phone/Fax
- Phone: 408-559-2011
- Fax:
- Phone: 510-350-2644
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
BIRDSALL
Title or Position: COO
Credential: MD
Phone: 510-350-2644