Provider Demographics
NPI:1417618117
Name:GALLI RASMUSSEN, LIVIA SPEARE (OD, MS)
Entity Type:Individual
Prefix:MRS
First Name:LIVIA
Middle Name:SPEARE
Last Name:GALLI RASMUSSEN
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:MS
Other - First Name:LIVIA
Other - Middle Name:CATHERINE SPEARE
Other - Last Name:GALLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD, MS
Mailing Address - Street 1:PO BOX 1184
Mailing Address - Street 2:
Mailing Address - City:SAN ANDREAS
Mailing Address - State:CA
Mailing Address - Zip Code:95249-1184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:940 SYLVA LN STE H
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5969
Practice Address - Country:US
Practice Address - Phone:209-532-4123
Practice Address - Fax:209-532-6749
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35195TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist