Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | G18435 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 16450 | CO |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | G18435 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD00009497 | WA |
NPI | 1649260803 |
---|---|
Provider Name | Dr. Richard Galich |
First Address | Glendora, CA 91740-0428 |
Second Address | Glendora, CA 91741-1844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 26/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A40346 | (02) |