Provider Demographics
NPI:1861417057
Name:GALINDO, MICHAEL SEBASTIAN (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SEBASTIAN
Last Name:GALINDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MIGUEL
Other - Middle Name:SEBASTIAN
Other - Last Name:GALINDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:184 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-4804
Mailing Address - Country:US
Mailing Address - Phone:801-953-0871
Mailing Address - Fax:
Practice Address - Street 1:36 S STATE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1401
Practice Address - Country:US
Practice Address - Phone:801-408-5482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7693740-1205208M00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A843560Medicaid
CA00A843560Medicaid
CAWA84356AMedicare PIN