Basic Information
Provider Information
NPI: 1477906758
EntityType: 2
ReplacementNPI:  
OrganizationName: GALEN INPATIENT PHYSICIANS INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: VITUITY
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 2100 POWELL ST STE 900
Address2:  
City: EMERYVILLE
State: CA
PostalCode: 946081844
CountryCode: US
TelephoneNumber: 5103502600
FaxNumber:  
Practice Location
Address1: 2425 SAMARITAN DR
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951243908
CountryCode: US
TelephoneNumber: 4085592011
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/21/2016
LastUpdateDate: 02/15/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BIRDSALL
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF OPERATIONS OFFICER
AuthorizedOfficialTelephone: 5103502600
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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