Basic Information
Provider Information
NPI: 1528312758
EntityType: 2
ReplacementNPI:  
OrganizationName: GALEN INPATIENT PHYSICIANS PC
LastName:  
FirstName:  
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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: 5103502638
FaxNumber:  
Practice Location
Address1: 2175 ROSALINE AVE
Address2:  
City: REDDING
State: CA
PostalCode: 960012549
CountryCode: US
TelephoneNumber: 5302506000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/09/2012
LastUpdateDate: 06/08/2021
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: 06/08/2021

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

No ID Information.


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