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General NPI Number Information
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NPI Number | 1811848351
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Entity Type | Organization
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Legal Business Name | THE GALAXY FREE CLINIC
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 10121 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90044-3113
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Country | US
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Telephone | 323-374-5798
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Fax |
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Provider Business Mailing Address
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Address Line | 6435 S SHERBOURNE DR
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City | LOS ANGELES
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State | CA
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Zip | 90056-2119
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LATESHA TIFFANY REED
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Credential | DNP, NP
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Telephone | 310-508-7865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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