Provider Demographics
NPI:1386349165
Name:GALVAN, ABRAHAM (APCC)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:GALVAN
Suffix:
Gender:M
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11636 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BALLICO
Mailing Address - State:CA
Mailing Address - Zip Code:95303-9701
Mailing Address - Country:US
Mailing Address - Phone:858-336-0156
Mailing Address - Fax:
Practice Address - Street 1:11636 PARK ST
Practice Address - Street 2:
Practice Address - City:BALLICO
Practice Address - State:CA
Practice Address - Zip Code:95303-9701
Practice Address - Country:US
Practice Address - Phone:858-336-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC17103390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program