Provider Demographics
NPI:1255619318
Name:GALAN, DANIEL P (CPO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:GALAN
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3369 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6814
Mailing Address - Country:US
Mailing Address - Phone:951-782-7000
Mailing Address - Fax:951-489-0422
Practice Address - Street 1:3369 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-6814
Practice Address - Country:US
Practice Address - Phone:951-782-7000
Practice Address - Fax:951-489-0422
Is Sole Proprietor?:No
Enumeration Date:2011-07-23
Last Update Date:2011-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CPO02636222Z00000X
CACPO02636224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist