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Contact Information

JOHN GALLO, MD
721 RIVER DR
SUITE A
FORT BRAGG, CA95437
 Phone: 707-961-4631
 Fax: 707-964-1192
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JOHN GALLO · (Male)

NPI Number 1225049257
Status Active
Credentials MD
Entity Individual
Enumeration date 08/11/2006
Last updated 10/16/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # C36010
  • CA Other 00C360100 MEDI-CAL
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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