Healthcare Provider Details

I. General information

NPI: 1386337228
Provider Name (Legal Business Name): AURORA GALVAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5404 MORENO ST STE G
MONTCLAIR CA
91763-1665
US

IV. Provider business mailing address

1147 N LOTUS ST
ANAHEIM CA
92801-1731
US

V. Phone/Fax

Practice location:
  • Phone: 909-949-4400
  • Fax:
Mailing address:
  • Phone: 714-313-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95025374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: