1952451049 NPI number — MARK GALBRAITH, M.D., INC.

Table of content: (NPI 1952451049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952451049 NPI number — MARK GALBRAITH, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARK GALBRAITH, M.D., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1952451049
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26732 CROWN VALLEY PKWY STE 511
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSION VIEJO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92691-8525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-360-6009
Provider Business Mailing Address Fax Number:
949-360-6162

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26691 PLAZA
Provider Second Line Business Practice Location Address:
110
Provider Business Practice Location Address City Name:
MISSION VIEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92691-6329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-360-6009
Provider Business Practice Location Address Fax Number:
949-360-6162
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GALBRAITH
Authorized Official First Name:
JON
Authorized Official Middle Name:
MARK
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
949-360-6009

Provider Taxonomy Codes

  • Taxonomy code: 207QS0010X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1780619916 . This is a "INDIVIDUAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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