MEDICARE: MARIETTA GALANG

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
1	163W00000X	Registered Nurse	648431	CA
2	163WX0003X	Inpatient Obstetric Registered Nurse	648431	CA

General Provider Information

NPI Number	:	1184872392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIETTA GALANG

Provider Business Mailing Address
First Line	:	1249 LONG VIEW DRIVE
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91915
Country	:	US
Telephone Number	:	619-781-8681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1249 LONG VIEW DRIVE
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91915
Country	:	US
Telephone Number	:	619-781-8681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	08/29/2008

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