MEDICARE: ABSALON GALAT

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	A129510	CA

General Provider Information

NPI Number	:	1891050753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABSALON GALAT

Provider Business Mailing Address
First Line	:	6551 VAN NUYS BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1566
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6551 VAN NUYS BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1566
Country	:	US
Telephone Number	:	818-627-3050
Fax Number	:

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

Provider Enumeration Date	:	07/06/2012
Last Update Date	:	06/09/2020

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Directions to “ ABSALON GALAT ” Practice Location

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