Provider Demographics
NPI:1043245640
Name:GALIER, PETER CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:CHARLES
Last Name:GALIER
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 1:5767 W. CENTURY BLVD
Mailing Address - Street 2:#400
Mailing Address - City:LOS ANGLES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5655
Mailing Address - Country:US
Mailing Address - Phone:310-828-7172
Mailing Address - Fax:310-394-7807
Practice Address - Street 1:200 MEDICAL PLAZA
Practice Address - Street 2:#214,365,530,420,120
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3075
Practice Address - Country:US
Practice Address - Phone:310-458-2381
Practice Address - Fax:310-260-2963
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74741207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G747410Medicaid
CAWG74741AMedicare PIN
CAF76495Medicare UPIN