Provider Demographics
NPI:1144063579
Name:GALVEZ, NATHALIE MARIE
Entity type:Individual
Prefix:MISS
First Name:NATHALIE
Middle Name:MARIE
Last Name:GALVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10334 BLUMONT RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-5343
Mailing Address - Country:US
Mailing Address - Phone:323-346-4030
Mailing Address - Fax:
Practice Address - Street 1:10334 BLUMONT RD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-5343
Practice Address - Country:US
Practice Address - Phone:323-346-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20084171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist