Provider Demographics
NPI:1023445855
Name:GALLAP, GEORGE (RT(R))
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:GALLAP
Suffix:
Gender:M
Credentials:RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 MCFARLAN ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1345
Mailing Address - Country:US
Mailing Address - Phone:207-712-3653
Mailing Address - Fax:
Practice Address - Street 1:1435 MCFARLAN ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1345
Practice Address - Country:US
Practice Address - Phone:207-712-3653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000700412471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography