Basic Information
Provider Information
NPI: 1003002932
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALUSKA
FirstName: MICHAEL
MiddleName: ANDREW
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 793 ALDEA DR
Address2:  
City: OCEANSIDE
State: CA
PostalCode: 920572719
CountryCode: US
TelephoneNumber: 7175862062
FaxNumber:  
Practice Location
Address1: BUILDING H100
Address2: NAVAL HOSPITAL CAMP PENDLETON
City: CAMP PENDLETON
State: CA
PostalCode: 92055
CountryCode: US
TelephoneNumber: 7607251620
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/25/2007
LastUpdateDate: 02/16/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD433991PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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