Provider Demographics
NPI:1427212364
Name:GALEY, BRIAN STRAUD (LVN)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:STRAUD
Last Name:GALEY
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6091 ATLAS DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2402
Mailing Address - Country:US
Mailing Address - Phone:562-929-6688
Mailing Address - Fax:562-929-6838
Practice Address - Street 1:12440 FIRESTONE BLVD STE 3025
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-9331
Practice Address - Country:US
Practice Address - Phone:562-929-6688
Practice Address - Fax:562-929-6838
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233976164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1669560488Medicaid