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General NPI Number Information
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NPI Number | 1649260803
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Entity Type | Individual
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Provider Name | RICHARD GALICH MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 926 W DONINGTON ST
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City | GLENDORA
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State | CA
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Zip | 91741-1844
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Country | US
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Telephone | 626-644-0840
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | GLENDORA
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State | CA
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Zip | 91740-0428
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Country | US
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Telephone | 626-644-0840
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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 | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | G18435
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 16450
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | MD00009497
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G18435
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License Number State | CA
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