=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265641849
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIC ARTHUR GALLA D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2007
-----------------------------------------------------
Last Update Date | 05/02/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9330 W FLAMINGO RD STE 112A
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89147-6447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-944-3300
-----------------------------------------------------
Fax | 760-944-8581
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9330 W FLAMINGO RD STE 112A
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89147-6447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-932-6100
-----------------------------------------------------
Fax | 702-932-6100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 22338
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC22338
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | B01699
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------