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MRS. KATHLEEN EMILIE GALLAHER M.D.
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1114034808
Individual Registrant:MRS. KATHLEEN EMILIE GALLAHER M.D.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
17871 SANTIAGO BLVD SUITE 206 FIRST FLOOR VILLA PARK, CA 92861-4141 US
Tel: 714-974-1362 Fax: 714-974-3145
Tel: 714-974-1362 Fax: 714-974-3145
Contact information for business:
17871 SANTIAGO BLVD SUITE 206 FIRST FLOOR VILLA PARK, CA 92861-4141 US
Tel: 714-974-1362 Fax: 714-974-3145
Tel: 714-974-1362 Fax: 714-974-3145
Registration Information:
NPI: 1114034808
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | CA | A40219 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| DEA | AG2636910 | 01 | |
| RAILROAD MEDICARE | P00004108 | CA | 01 |
| CLIA | 05D1010073 | 01 |
