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1194079582
JUSTIN SHANE GALLEGOS
LOS GATOS, CA
NPI
1194079582
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-11-06
Last Update Date
2012-11-06
Business Address
-- JUSTIN SHANE GALLEGOS
16400 BLOSSOM HILL RD
LOS GATOS, CA 95032-3553
Phone number: 408-335-2100
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Mailing Address
-- JUSTIN SHANE GALLEGOS
72 CANNERY CIR
CAMPBELL, CA 95008-1442
Phone number: 408-705-6821
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