Provider Demographics
NPI:1801890405
Name:GALA, KIRIT V (MD)
Entity type:Individual
Prefix:
First Name:KIRIT
Middle Name:V
Last Name:GALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-2631
Mailing Address - Country:US
Mailing Address - Phone:626-379-5565
Mailing Address - Fax:626-270-4368
Practice Address - Street 1:414 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-2631
Practice Address - Country:US
Practice Address - Phone:626-379-5565
Practice Address - Fax:626-270-4368
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2020-06-09
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
CAA35300207RH0003X
CAA35360207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A35360Medicare ID - Type Unspecified
A27760Medicare UPIN
CA00A353601Medicare ID - Type Unspecified