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General NPI Number Information
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NPI Number | 1073497350
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Entity Type | Individual
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Provider Name | MARIA RENALYN RED DE GALA RNFA
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Gender | Female
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 1300 W 7TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90732-3505
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Country | US
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Telephone | 310-832-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 4524 N CLYBOURN AVE APT 215
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City | BURBANK
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State | CA
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Zip | 91505-3901
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Country | US
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Telephone | 714-804-3464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 95298806
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License Number State | CA
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