Provider Demographics
NPI:1114573565
Name:GARCIA, LAURA MARIBEL I
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MARIBEL
Last Name:GARCIA
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 WESTMINSTER AVE APT 219
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2186
Mailing Address - Country:US
Mailing Address - Phone:714-597-1239
Mailing Address - Fax:
Practice Address - Street 1:5200 IRVINE BLVD SPC 339
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-2058
Practice Address - Country:US
Practice Address - Phone:619-433-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider