Provider Demographics
NPI:1295951937
Name:NEAL GALEN, D.O., P.C.
Entity type:Organization
Organization Name:NEAL GALEN, D.O., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-246-4917
Mailing Address - Street 1:1728 WEST GLENDALE AVENUE
Mailing Address - Street 2:SUITE #103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-6288
Mailing Address - Country:US
Mailing Address - Phone:602-246-4917
Mailing Address - Fax:602-246-1432
Practice Address - Street 1:1728 WEST GLENDALE AVENUE
Practice Address - Street 2:SUITE #103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-6288
Practice Address - Country:US
Practice Address - Phone:602-246-4917
Practice Address - Fax:602-246-1432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1760208600000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ204131OtherAHCCCS
AZ204131Medicaid
AZE44489Medicare UPIN
E44489Medicare UPIN
AZ204131OtherAHCCCS