Provider Demographics
NPI:1093943847
Name:GARCIA, AIREL (PTA)
Entity Type:Individual
Prefix:
First Name:AIREL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11677 SAN VICENTE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5128
Mailing Address - Country:US
Mailing Address - Phone:310-826-3110
Mailing Address - Fax:310-826-5990
Practice Address - Street 1:11677 SAN VICENTE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5128
Practice Address - Country:US
Practice Address - Phone:310-826-3110
Practice Address - Fax:310-826-5990
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT8967225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAT8967OtherPHYSICAL THERAPY ASSISTANT LICENCE