Healthcare Provider Details

I. General information

NPI: 1407290968
Provider Name (Legal Business Name): MICHAEL JOHN GALE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 W WARM SPRINGS RD
LAS VEGAS NV
89113-3612
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 702-492-8614
  • Fax: 702-492-8163
Mailing address:
  • Phone: 24-064-7866
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number18284
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number18284
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: