MEDICARE: ELIZABETH GALDAMEZ

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	104100000X	Social Worker	ASW72100	CA

General Provider Information

NPI Number	:	1528430709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH GALDAMEZ

Provider Business Mailing Address
First Line	:	1968 W ADAMS BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-3515
Country	:	US
Telephone Number	:	323-733-0322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1968 W ADAMS BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-3515
Country	:	US
Telephone Number	:	323-733-0322
Fax Number	:

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

Provider Enumeration Date	:	10/27/2015
Last Update Date	:	08/19/2016

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Directions to “ ELIZABETH GALDAMEZ ” Practice Location

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