Basic Information
Provider Information
NPI: 1326389289
EntityType: 2
ReplacementNPI:  
OrganizationName: GALEN INPATIENT PHYSICIANS INC
LastName:  
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Credential:  
OtherOrganizationName: VITUITY
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 1601 CUMMINS DR STE D
Address2:  
City: MODESTO
State: CA
PostalCode: 953586411
CountryCode: US
TelephoneNumber: 5103502666
FaxNumber: 5108799061
Practice Location
Address1: 15615 POMERADO RD
Address2:  
City: POWAY
State: CA
PostalCode: 920642405
CountryCode: US
TelephoneNumber: 8586134000
FaxNumber: 8586134217
Other Information
ProviderEnumerationDate: 03/01/2013
LastUpdateDate: 06/08/2021
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BIRDSALL
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF OPERATIONS OFFICER
AuthorizedOfficialTelephone: 5103502600
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate: 06/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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