Individual
JENNY R. GALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13112 EVENING CREEK DR S, SAN DIEGO, CA 92128-4108
(858) 668-4392
(310) 698-7054
Mailing address
2374 E PACIFICA PL, RANCHO DOMINGUEZ, CA 90220-6214
(310) 225-3244
(310) 698-7054
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
G83749
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G83749
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13235
MEDICAL LICENSE
NV
01
—
37429
MEDICAL LICENSE
AZ
01
—
DR-49244
MEDICAL LICENSE
CO
01
—
MD153421
MEDICAL LICENSE
OR
01
—
MD2010-0236
MEDICAL LICENSE
NM
Enumeration date
05/18/2006
Last updated
01/27/2016
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