Healthcare Provider Details

I. General information

NPI: 1790788693
Provider Name (Legal Business Name): FRANK C GALLI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 HOSPITAL DR SUITE 311
MOUNTAIN VIEW CA
94040
US

IV. Provider business mailing address

2490 HOSPITAL DR SUITE 311
MOUNTAIN VIEW CA
94040
US

V. Phone/Fax

Practice location:
  • Phone: 650-962-4690
  • Fax: 650-962-4696
Mailing address:
  • Phone: 650-962-4690
  • Fax: 650-962-4696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG65731
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG65731
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG65731
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: