Healthcare Provider Details

I. General information

NPI: 1780799809
Provider Name (Legal Business Name): STANLEY PAUL GALANT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W LA VETA AVE STE 501
ORANGE CA
92868-4213
US

IV. Provider business mailing address

1728 SANTIAGO DR
NEWPORT BEACH CA
92660-4358
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-7994
  • Fax: 714-744-4167
Mailing address:
  • Phone: 949-645-3141
  • Fax: 714-744-4167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA21143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: