Healthcare Provider Details

I. General information

NPI: 1477066793
Provider Name (Legal Business Name): MS. CHYNNA KADEE GALANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 FOLSOM ST FL 1
SAN FRANCISCO CA
94107-4226
US

IV. Provider business mailing address

293 LAKESHORE DR
SAN FRANCISCO CA
94132-1119
US

V. Phone/Fax

Practice location:
  • Phone: 185-583-2672
  • Fax: 772-675-9100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: