Provider Demographics
NPI:1437379575
Name:GALGO, GEOFFREY PERPETUA (DOCTOR OF MEDICINE)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:PERPETUA
Last Name:GALGO
Suffix:
Gender:M
Credentials:DOCTOR OF MEDICINE
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:744 N MARINE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-4426
Mailing Address - Country:US
Mailing Address - Phone:671-647-4174
Mailing Address - Fax:671-647-4199
Practice Address - Street 1:744 N MARINE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-4426
Practice Address - Country:US
Practice Address - Phone:671-647-4174
Practice Address - Fax:671-647-4199
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM-1250207Q00000X
GUM001250174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUH03364Medicare UPIN
GU52077Medicare ID - Type Unspecified