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Provider Information for 1891050753

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ABSALON GALAT

Other Name:   ABSALON GALAT
Gender: MALE

Individual NPI: 1891050753

Calendar   Last Updated:  2020-06-09
  Certification Date:  2020-06-09

Details

Name Value
NPI 1891050753
Enumeration Date 2012-07-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 6551 VAN NUYS BLVD
VAN NUYS, CA 91401-1566
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 6551 VAN NUYS BLVD
VAN NUYS, CA 91401-1566
United States

Phone: 818-627-3050 | Fax:
View Map External Link
Secondary Practice Address 1402 LOMITA BLVD STE 200
HARBOR CITY, CA 90710-2025
United States

Phone: 310-534-7600 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207Q00000X - Family Medicine CA A129510
No 390200000X - Student in an Organized Health Care Education/Training Program