MEDICARE: GINA ALEXANDRA GALVEZ MS, PA

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	363AM0700X	Medical Physician Assistant	017298	NY

General Provider Information

NPI Number	:	1952724247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA ALEXANDRA GALVEZ MS, PA

Provider Business Mailing Address
First Line	:	3117 5TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-5605
Country	:	US
Telephone Number	:	718-208-5575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1234 6TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1613
Country	:	US
Telephone Number	:	310-451-8880
Fax Number	:	310-451-8803

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

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	09/11/2025

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