Provider Demographics
NPI:1104554104
Name:GALERO, DENISE ANTONNETTE ESPINO
Entity type:Individual
Prefix:
First Name:DENISE ANTONNETTE
Middle Name:ESPINO
Last Name:GALERO
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 1:7000 LA PALMA AVE APT B210
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-2455
Mailing Address - Country:US
Mailing Address - Phone:323-439-0666
Mailing Address - Fax:
Practice Address - Street 1:2971 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90810-2948
Practice Address - Country:US
Practice Address - Phone:562-989-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302418225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist