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General NPI Number Information
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NPI Number | 1689926719
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Entity Type | Organization
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Legal Business Name | GALLERIA MEDICAL SUPPLY
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Dates
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Enumeration Date | 10/13/2012
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 3250 W OLYMPIC BLVD SUITE 301
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City | LOS ANGELES
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State | CA
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Zip | 90006-2368
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Country | US
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Telephone | 323-737-8585
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Fax | 323-737-8586
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Provider Business Mailing Address
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Address Line | 3250 W OLYMPIC BLVD SUITE 301
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City | LOS ANGELES
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State | CA
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Zip | 90006-2368
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Country | US
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Telephone | 323-737-8585
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Fax | 323-737-8586
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Authorized Official
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Title or Position | PRESIDENT
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Name | MINSU KIM
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Credential |
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Telephone | 323-737-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | CA
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