Provider Demographics
NPI:1205384310
Name:GARCIA, ELIZABETH (NP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S GRAND AVE
Mailing Address - Street 2:707
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3048
Mailing Address - Country:US
Mailing Address - Phone:323-839-1119
Mailing Address - Fax:323-389-1120
Practice Address - Street 1:4499 VIA MARISOL
Practice Address - Street 2:111A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-5147
Practice Address - Country:US
Practice Address - Phone:510-541-0892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-18
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003163363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health