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NPI Code Detail

MEDICARE: LANA LOUIE A. WANIA-GALICIA MD

MEDICARE:   LANA LOUIE A. WANIA-GALICIA  MD
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
1207LP2900XPain Medicine (Anesthesiology) PhysicianA80078CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00036928OTHERCARAILROAD MEDICARE PIN

General Provider Information

NPI Number : 1730166406
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANA LOUIE A. WANIA-GALICIA MD
Provider Business Mailing Address
First Line : 530 W LOS ANGELES AVE
Second Line : STE 115, MS 343
City : MOORPARK
State : CA
Zip : 93021-1746
Country : US
Telephone Number : 805-222-4549
Fax Number : 805-529-4549
Provider Business Practice Location Address
First Line : 865 PATRIOT DR
Second Line : SUITE 201A
City : MOORPARK
State : CA
Zip : 93021-3407
Country : US
Telephone Number : 805-222-4549
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 07/15/2015

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Directions to “ LANA LOUIE A. WANIA-GALICIA MD” Practice Location

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