Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A122755 | CA |
N | 207XS0106X | Orthopaedic Hand Surgeon | A122755 | CA |
Y | 208200000X | Surgeon | A122755 | CA |
Y | 208600000X | Surgeon | A122755 | CA |
N | 2082S0105X | Plastic Hand Surgeon | A122755 | CA |
NPI | 1619266111 |
---|---|
Provider Name | Michael Gabriel Galvez |
First Address | Madera, CA 93636-8762 |
Second Address | Madera, CA 93636-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 12/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1619266111 | (05) | CA |