Provider Demographics
NPI:1114536943
Name:ALARCON GALAN, EILIER (MD,PA,RDMS,RPT,RMA)
Entity type:Individual
Prefix:DR
First Name:EILIER
Middle Name:
Last Name:ALARCON GALAN
Suffix:
Gender:M
Credentials:MD,PA,RDMS,RPT,RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12329 N 121ST AVE
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-3349
Mailing Address - Country:US
Mailing Address - Phone:602-544-7772
Mailing Address - Fax:
Practice Address - Street 1:6114 N 59TH AVE STE 6
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-7770
Practice Address - Country:US
Practice Address - Phone:623-937-8643
Practice Address - Fax:623-934-1249
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ198878247100000X, 2471S1302X, 202K00000X, 2085U0001X
PR002074-PA363AM0700X, 363A00000X
FLTPPA687363A00000X, 363AM0700X
ZZ105453207Q00000X, 207R00000X
AZ202010152365246RP1900X
105453170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics