Provider Demographics
NPI:1225540115
Name:GARZA-CONTRERAS, JORGE G (DC)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:G
Last Name:GARZA-CONTRERAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3773
Mailing Address - Country:US
Mailing Address - Phone:408-409-4560
Mailing Address - Fax:
Practice Address - Street 1:590 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3773
Practice Address - Country:US
Practice Address - Phone:408-409-4560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33986111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor