Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G80598 | CA |
N | 111NI0900X | Internist | G80598 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | G80598 | CA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 65276 | MN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | G80598 | CA |
NPI | 1033100045 |
---|---|
Provider Name | Donna M Gallik |
First Address | Pacific Palisades, CA 90272-2133 |
Second Address | Los Angeles, CA 90048-4312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 28/05/2019 |