Organization
GALLEGO PLASTIC SURGERY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY MATTHEW GALLEGO M.D. (PRESIDENT)
(714) 935-0073
Entity
Organization
Contact information
Practice address
4050 BARRANCA PKWY STE 220, IRVINE, CA 92604-1723
(877) 389-0368
(949) 502-6501
Mailing address
PO BOX 218, ORANGE, CA 92856-6218
(714) 935-0073
(714) 935-0075
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A84081
CA
Other
Enumeration date
01/10/2007
Last updated
08/22/2020
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