Healthcare Provider Details

I. General information

NPI: 1033629225
Provider Name (Legal Business Name): MICHELLE MAY GALVEZ RD, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 E COLORADO BLVD # 2013
PASADENA CA
91106-1932
US

IV. Provider business mailing address

1308 E COLORADO BLVD # 2013
PASADENA CA
91106-1932
US

V. Phone/Fax

Practice location:
  • Phone: 626-224-1011
  • Fax:
Mailing address:
  • Phone: 323-857-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86072112
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: