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NPI Code Detail

MEDICARE: MS. AMBER ALLYSEN GALLY PA-C

MEDICARE:  MS. AMBER ALLYSEN GALLY  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant22593CA

General Provider Information

NPI Number : 1023369956
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMBER ALLYSEN GALLY PA-C
Provider Business Mailing Address
First Line : 801 E KATELLA AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6614
Country : US
Telephone Number : 714-633-6373
Fax Number :
Provider Business Practice Location Address
First Line : 801 E KATELLA AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6614
Country : US
Telephone Number : 714-633-6373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2012
Last Update Date : 07/20/2022

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Directions to “ MS. AMBER ALLYSEN GALLY PA-C” Practice Location

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