Provider Demographics
NPI:1306532684
Name:GALBREATH, MATTHEW (CMT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:GALBREATH
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 EUCALYPTUS DR
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-2309
Mailing Address - Country:US
Mailing Address - Phone:310-745-0720
Mailing Address - Fax:
Practice Address - Street 1:5801 CRESTRIDGE RD
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-4961
Practice Address - Country:US
Practice Address - Phone:310-745-0720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31754225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist