Provider Demographics
NPI:1538516349
Name:GALOSO, REIBERT
Entity Type:Individual
Prefix:
First Name:REIBERT
Middle Name:
Last Name:GALOSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66756 CAHUILLA AVE
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-4037
Mailing Address - Country:US
Mailing Address - Phone:760-329-6369
Mailing Address - Fax:
Practice Address - Street 1:66756 CAHUILLA AVE
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-4037
Practice Address - Country:US
Practice Address - Phone:760-329-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-22
Last Update Date:2016-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker