Provider Demographics
NPI:1942285994
Name:GALANG, CIRILO F (MD)
Entity Type:Individual
Prefix:DR
First Name:CIRILO
Middle Name:F
Last Name:GALANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E EARLL DR
Mailing Address - Street 2:STE. 360
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2634
Mailing Address - Country:US
Mailing Address - Phone:602-241-5102
Mailing Address - Fax:602-241-5109
Practice Address - Street 1:202 E EARLL DR
Practice Address - Street 2:STE. 360
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2634
Practice Address - Country:US
Practice Address - Phone:602-241-5102
Practice Address - Fax:602-241-5109
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35031213174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0300249Medicaid
OH0300249Medicaid
OHGA0417185Medicare ID - Type Unspecified