Provider Demographics
NPI:1861648529
Name:GALLEGOS, PANFILA
Entity Type:Individual
Prefix:MRS
First Name:PANFILA
Middle Name:
Last Name:GALLEGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10012 NORWALK BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3362
Mailing Address - Country:US
Mailing Address - Phone:562-942-9625
Mailing Address - Fax:562-942-9695
Practice Address - Street 1:10012 NORWALK BLVD STE 140
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3362
Practice Address - Country:US
Practice Address - Phone:562-942-9625
Practice Address - Fax:562-942-9695
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator