Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | A134887 | CA |
N | 2081P2900X | Pain Medicine | A134887 | CA |
N | 2084N0400X | Neurologist | A134887 | CA |
N | 2084N0600X | Clinical Neurophysiologist | A134887 | CA |
NPI | 1114313087 |
---|---|
Provider Name | Igor Galan |
First Address | Santa Maria, CA 93454 |
Second Address | Santa Maria, CA 93454-4607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 22/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2084N0008X | (05) | CA |
2084N0400X | (05) | CA |
2084N0600X | (05) | CA |
2084P2900X | (05) | CA |
2084S0010X | (05) | CA |
208VP0000X | (05) | CA |
208VP0014X | (05) | CA |