Provider Demographics
NPI:1306311949
Name:BEN GAL, NIR
Entity type:Individual
Prefix:
First Name:NIR
Middle Name:
Last Name:BEN GAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18229 TOPHAM ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-7302
Mailing Address - Country:US
Mailing Address - Phone:818-770-4392
Mailing Address - Fax:
Practice Address - Street 1:18229 TOPHAM ST
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91335-7302
Practice Address - Country:US
Practice Address - Phone:818-770-4392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health