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Organization
GALLERIA MEDICAL CLINIC, INC.
Active
Organization
GALLERIA MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINEO D TIANGCO M.D. (M.D.)
(619) 479-0320
Entity
Organization
Contact information
Practice address
2340 E 8TH ST, SUITE J, NATIONAL CITY, CA 91950-2869
(619) 479-0320
(619) 479-0367
Mailing address
2340 E 8TH ST, SUITE J, NATIONAL CITY, CA 91950-2869
(619) 479-0320
(619) 479-0367
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A52655
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A52655
MEDICARE PTAN
CA
Enumeration date
03/17/2007
Last updated
02/25/2015
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