MEDICARE: TIMOTHY EUJIN GALLAGHER SUDRC II #22514

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	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1699658393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY EUJIN GALLAGHER SUDRC II #22514

Provider Business Mailing Address
First Line	:	14371 WEBBER PL
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4308
Country	:	US
Telephone Number	:	657-688-2111
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 W MACARTHUR BLVD STE 201
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-6972
Country	:	US
Telephone Number	:	949-875-0807
Fax Number	:

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

Provider Enumeration Date	:	07/29/2025
Last Update Date	:	06/07/2026

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