Provider Demographics
NPI:1912968496
Name:GALLEMORE, RON P (MD)
Entity Type:Individual
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First Name:RON
Middle Name:P
Last Name:GALLEMORE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:220
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4504
Mailing Address - Country:US
Mailing Address - Phone:310-944-9393
Mailing Address - Fax:310-944-3393
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:220
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4504
Practice Address - Country:US
Practice Address - Phone:310-944-9393
Practice Address - Fax:310-944-3393
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2012-12-05
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Provider Licenses
StateLicense IDTaxonomies
CAG782400207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ74423ZMedicaid
G30650Medicare UPIN
CAZZZ74423ZMedicaid