Provider Demographics
NPI:1629379391
Name:MAGALAD, GARY C (RCP)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:C
Last Name:MAGALAD
Suffix:
Gender:M
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 OAKHURST DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2559
Mailing Address - Country:US
Mailing Address - Phone:909-272-0983
Mailing Address - Fax:
Practice Address - Street 1:819 OAKHURST DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2559
Practice Address - Country:US
Practice Address - Phone:909-272-0983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000241242278E0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278E0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedEmergency Care