Healthcare Provider Details

I. General information

NPI: 1619783156
Provider Name (Legal Business Name): CONNOR GALBRAITH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26401 CROWN VALLEY PKWY STE 101
MISSION VIEJO CA
92691-6302
US

IV. Provider business mailing address

23592 WINDSONG APT 24K
ALISO VIEJO CA
92656-1382
US

V. Phone/Fax

Practice location:
  • Phone: 949-340-4000
  • Fax: 949-348-7466
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: