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Individual

DR. GARY GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3080 VICTOR AVE, REDDING, CA 96002-1449
(530) 222-3166
(530) 222-6539
Mailing address
3080 VICTOR AVE, REDDING, CA 96002-1449
(530) 222-3166
(530) 222-6539

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6443T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1699740456
INDIVIDUAL NPI
CA
01
CA408836
MEDICARE GROUP PTAN
CA
01
CA412404
INDIVIDUAL MEDICARE PTAN
CA
05
SD0064430
CA
Enumeration date
02/22/2006
Last updated
10/15/2020
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