Individual
MARTHA GALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 ARMORLITE DR APT 102, SAN MARCOS, CA 92069
(619) 559-4096
Mailing address
1227 ARMORLITE DR APT 102, SAN MARCOS, CA 92069-1429
(619) 559-4096
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
374700213
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
374700213
HCO
—
Enumeration date
07/05/2018
Last updated
07/06/2018
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