Healthcare Provider Details

I. General information

NPI: 1780619916
Provider Name (Legal Business Name): JON MARK GALBRAITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARK GALBRAITH M.D.

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26732 CROWN VALLEY PKWY STE 511
MISSION VIEJO CA
92691-8525
US

IV. Provider business mailing address

26732 CROWN VALLEY PKWY STE 511
MISSION VIEJO CA
92691-8525
US

V. Phone/Fax

Practice location:
  • Phone: 949-360-6009
  • Fax: 949-360-6162
Mailing address:
  • Phone: 949-360-6009
  • Fax: 949-360-6162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberA66070
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA66070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: