Healthcare Provider Details

I. General information

NPI: 1356531206
Provider Name (Legal Business Name): JEFFREY E GALPIN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 ETIWANDA AVE STE 308
TARZANA CA
91356-6124
US

IV. Provider business mailing address

5525 ETIWANDA AVE STE 308
TARZANA CA
91356-6124
US

V. Phone/Fax

Practice location:
  • Phone: 818-344-6111
  • Fax: 818-344-5056
Mailing address:
  • Phone: 818-344-6111
  • Fax: 818-344-5056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG22170
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberG22170
License Number StateCA

VIII. Authorized Official

Name: JEFFREY E. GALPIN
Title or Position: PRESIDENT
Credential: MD
Phone: 818-344-6111