Provider Demographics
NPI:1114736303
Name:GALLINI, GIORGIO (OT)
Entity type:Individual
Prefix:
First Name:GIORGIO
Middle Name:
Last Name:GALLINI
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 S DETROIT ST APT 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3554
Mailing Address - Country:US
Mailing Address - Phone:213-631-1741
Mailing Address - Fax:
Practice Address - Street 1:465 S DETROIT ST APT 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3554
Practice Address - Country:US
Practice Address - Phone:213-631-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18486225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty