1801890405 NPI number — KIRIT V GALA MD

Table of content: KIRIT V GALA MD (NPI 1801890405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801890405 NPI number — KIRIT V GALA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALA
Provider First Name:
KIRIT
Provider Middle Name:
V
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1801890405
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/21/2006
NPI Reactivation Date:
03/27/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
414 CAMBRIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARCADIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91007-2631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-379-5565
Provider Business Mailing Address Fax Number:
626-270-4368

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 CAMBRIDGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCADIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91007-2631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-379-5565
Provider Business Practice Location Address Fax Number:
626-270-4368
Provider Enumeration Date:
06/10/2005

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: 207RH0003X , with the licence number:  A35300 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: A35360 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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