Active NPI
Galen Inpatient Physician
- Internal Medicine Physician
- Ukiah, CA
National Provider Identifier
1265524441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- GALEN INPATIENT PHYSICIAN
- Practice address
- 275 Hospital Dr
Ukiah, CA 95482-4531 - Phone
- (707) 462-3111
- NPI assigned
- Sep 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Leslie Anglada
- Title
- Coo
- Phone
- (510) 350-2661
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
275 Hospital Dr
Ukiah, CA 95482-4531
Mailing address
2100 Powell St
Ste 900
Emeryville, CA 94608-1826
Phone (510) 350-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0093523 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040322000680 | CA | Part B Supplier - Clinic/Group Practice | 3678464633 |
Receives reassigned benefits from 977 practitioners This NPI is an additional NPI on the enrollment Practice locations: Oxnard, CA; Redding, CA; Roseville, CA; Saint Helena, CA; San Luis Obispo, CA; Selma, CA; Simi Valley, CA; Sonora, CA… |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187654400000",
"number": "1265524441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL ST",
"address_2": "STE 900",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081826",
"telephone_number": "510-350-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 HOSPITAL DR",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824531",
"telephone_number": "707-462-3111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GALEN INPATIENT PHYSICIAN",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-28",
"last_updated": "2007-08-21",
"status": "A",
"authorized_official_last_name": "ANGLADA",
"authorized_official_first_name": "LESLIE",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "510-350-2661",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0093523",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.