Healthcare Provider Details

I. General information

NPI: 1275608986
Provider Name (Legal Business Name): ALFONSO G GALINDO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALFONSO G GALINDO DDS

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 INTERNATIONAL BLVD
OAKLAND CA
94601-2228
US

IV. Provider business mailing address

2950 INTERNATIONAL BLVD STE 208
OAKLAND CA
94601-2228
US

V. Phone/Fax

Practice location:
  • Phone: 510-535-4450
  • Fax: 510-532-4494
Mailing address:
  • Phone: 510-535-4450
  • Fax: 510-535-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number40352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: