SAMUEL ANTONIO GALICIA (NPI# 1104238104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104238104 |
| Entity Type | Individual |
| Full Name | SAMUEL ANTONIO GALICIA |
| Credential | M.D. |
| Practice Address |
1721 W Yosemite Ave Manteca CA 95337-5130 |
| Practice Telephone | 2098253700 |
| Mailing Telephone | 2098253700 |
| Enumeration Date | 2014-05-24 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 145065 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16 Guion Pl, New Rochelle, NY 108015502 | 9143653680 |
| Street Address |
1721 W YOSEMITE AVE |
| City | MANTECA |
| State | CA |
| Zip Code | 95337-5130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942283700 | Elizabeth Ann Cliburn | Family Medicine | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2005-11-26 |
| 1215543202 | Gilberto Rodriguez | Respiratory Therapist, Registered | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2020-09-16 |
| 1649891755 | Athena Bechere | Dietitian, Registered | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2020-04-29 |
| 1841854189 | Kenzi Ellen Mather | Physical Therapist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2019-04-23 |
| 1114498789 | Lisa Michelle Gitthens Moses | Internal Medicine | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2018-12-07 |
| 1578030953 | Edmon Artinyan | Psychologist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2018-10-24 |
| 1902311756 | Lily Victoria Kadosh | Psychologist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-12-01 |
| 1205361474 | Kyle K Kato | Pharmacist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-04-26 |
| 1205361896 | Jeffrey Meath | Pharmacist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-04-21 |
| 1104350743 | Shama Afzal | Pharmacist | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2017-04-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640485 | Shanitta D Hines | Counselor | Victor Community Support Services, 302 Cherry Lane, CA 95337 | 2020-08-19 |
| 1548658685 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 401 S Airport Way, Manteca, CA 95337 | 2014-12-23 |
| 1225430655 | Elizabeth Julia Ann Tyner | Hearing Instrument Specialist | 1079 Eucalyptus, Suite B, Manteca, CA 95337 | 2014-09-17 |
| 1134565740 | Aegis Treatment Centers, LLC | Clinic/Center | 955 W. Center Street, Suites 12a, 12b & 14, Manteca, CA 95337 | 2013-05-22 |
| 1053668947 | Roger Cabo Inciong | Physical Therapist | 3652 Rapallo Way, Manteca, CA 95337 | 2012-08-09 |
| 1295997757 | Costco Wholesale Corporation | Pharmacy | 2440 Daniels St, Manteca, CA 95337 | 2008-06-26 |
| 1255474235 | Carmen Catherine Nunes | Marriage & Family Therapist | 1771 Yosemite Ave., Manteca, CA 95337 | 2007-02-15 |
| 1063577062 | Kathy Laverne Barron | Counselor | 1789 W. Yosemite Ave., Sierra Building, 1st Floor, Manteca, CA 95337 | 2006-12-27 |
| 1891853149 | R. Ciccarelli, Dds., R. Joseph, Dds., M. El Farra, Dds., D. Saini, Dds | Dentist | 1507 W. Yosemite, Manteca, CA 95337 | 2006-12-05 |
| 1467528265 | Annie Mathew | Pharmacist | 1777 West Yosemite Ave, Manteca, CA 95337 | 2006-11-27 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932442704 | Gilda Camama | Internal Medicine | 1287 Maple Valley St, Manteca, CA 95336-5123 | 2013-03-31 |
| 1033409644 | Swati Pathak | Internal Medicine | 165 Saint Dominics Dr Ste 201, Manteca, CA 95337-7802 | 2011-04-15 |
| 1518128222 | Anita Kumari | Internal Medicine | 1138 Norman Dr, Manteca, CA 95336 | 2008-06-24 |
| 1053399980 | Abdul Waheed Khan | Internal Medicine | 1144 Norman Dr, Suite 205, Manteca, CA 95336-5925 | 2005-12-30 |
| 1760465710 | Randall Kelvin Yee | Internal Medicine | 165 Saint Dominics Dr, Suite #201, Manteca, CA 95337-7802 | 2005-11-23 |
| 1659354868 | Rahul Lalitchandra Patel | Internal Medicine | 1148 Norman Dr, Ste 4, Manteca, CA 95336-5961 | 2005-11-22 |
| 1992791180 | Anil K Sain | Internal Medicine | 1140 Norman Dr, Suite 1, Manteca, CA 95336-5900 | 2005-09-22 |
| 1851742118 | Kyi Lay San | Internal Medicine | 165 Saint Dominics Dr Ste 201, Manteca, CA 95337-7802 | 2016-06-28 |
| 1457783458 | Yosemite Inpatient Services, A Medical Corporation | Internal Medicine | 1205 E North St, Manteca, CA 95336-4932 | 2013-08-01 |
| 1003048745 | Puneet Dhillon Grewal | Internal Medicine | 1148 Norman Dr Ste 3, Manteca, CA 95336-5961 | 2009-08-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.