Provider Demographics
NPI:1295035442
Name:GANA, SEVERINO GALANG III (RN)
Entity Type:Individual
Prefix:MR
First Name:SEVERINO
Middle Name:GALANG
Last Name:GANA
Suffix:III
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10029 DAY CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-7212
Mailing Address - Country:US
Mailing Address - Phone:619-971-3992
Mailing Address - Fax:
Practice Address - Street 1:10029 DAY CREEK TRL
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-7212
Practice Address - Country:US
Practice Address - Phone:619-971-3992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA747274163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse