Provider Demographics
NPI:1780717587
Name:GALBRAITH, ROBERT G (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:GALBRAITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 280340
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91328-0340
Mailing Address - Country:US
Mailing Address - Phone:818-993-3151
Mailing Address - Fax:818-344-1739
Practice Address - Street 1:9545 RESEDA BLVD
Practice Address - Street 2:#4
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2351
Practice Address - Country:US
Practice Address - Phone:818-993-3151
Practice Address - Fax:818-344-1739
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36778208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G367780Medicaid
CA00G367780Medicaid
A91815Medicare UPIN