Provider Demographics
NPI:1437263571
Name:ANDAL, GALICANO C (MD)
Entity Type:Individual
Prefix:DR
First Name:GALICANO
Middle Name:C
Last Name:ANDAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2250 GLADSTONE DR STE 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5124
Mailing Address - Country:US
Mailing Address - Phone:925-439-3334
Mailing Address - Fax:925-439-2698
Practice Address - Street 1:2250 GLADSTONE DR
Practice Address - Street 2:STE. 3
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5124
Practice Address - Country:US
Practice Address - Phone:925-493-3334
Practice Address - Fax:925-439-2698
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA33888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA27287Medicare UPIN