Provider Demographics
NPI:1861431298
Name:GALLONI, LUIGI (MD)
Entity type:Individual
Prefix:
First Name:LUIGI
Middle Name:
Last Name:GALLONI
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:PO BOX 5411
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-8014
Mailing Address - Country:US
Mailing Address - Phone:323-271-4173
Mailing Address - Fax:213-621-9584
Practice Address - Street 1:1127 WILSHIRE BLVD
Practice Address - Street 2:STE 408
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3901
Practice Address - Country:US
Practice Address - Phone:323-271-4173
Practice Address - Fax:213-621-9584
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38436174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist