MEDICARE: DR. AIDA MARCELA GALAN D.M.D.

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	1223G0001X	General Practice Dentistry	50257	CA

General Provider Information

NPI Number	:	1265530554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AIDA MARCELA GALAN D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 24586
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95154-4586
Country	:	US
Telephone Number	:	408-377-8200
Fax Number	:	408-377-8206

Provider Business Practice Location Address
First Line	:	1706 HAMILTON AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5424
Country	:	US
Telephone Number	:	408-377-8200
Fax Number	:	408-377-8206

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/03/2021

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