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NPI Code Detail

MEDICARE: MR. JOHN PAUL GALLAGHER

MEDICARE: MR. JOHN PAUL GALLAGHER
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
1104100000XSocial Worker121059CA

General Provider Information

NPI Number : 1659067759
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN PAUL GALLAGHER
Provider Business Mailing Address
First Line : 6219 LAKEVIEW CIR
Second Line :
City : SAN RAMON
State : CA
Zip : 94582-4873
Country : US
Telephone Number : 925-698-4230
Fax Number :
Provider Business Practice Location Address
First Line : 2387 LISA LN
Second Line :
City : PLEASANT HILL
State : CA
Zip : 94523-3949
Country : US
Telephone Number : 925-393-4013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2023
Last Update Date : 02/17/2024

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