1770638314 NPI number — RUBEN GALARZA M.D.

Table of content: RUBEN GALARZA M.D. (NPI 1770638314)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770638314 NPI number — RUBEN GALARZA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALARZA
Provider First Name:
RUBEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770638314
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 24
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAUCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00698-0024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-836-2903
Provider Business Mailing Address Fax Number:
787-836-4298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LUIS MUNOZ RIVERA
Provider Second Line Business Practice Location Address:
307
Provider Business Practice Location Address City Name:
PENUELAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-836-2903
Provider Business Practice Location Address Fax Number:
787-836-4298
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  4800 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 203740 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 02693 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7682035 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3-4800 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25561 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2693 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25861 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4104800 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: SE4534 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 06526 . This is a "MEDICAL PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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