Provider Demographics
NPI:1265483622
Name:GARCIA, EUGENIA (MD)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2183
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-0183
Mailing Address - Country:US
Mailing Address - Phone:209-722-4548
Mailing Address - Fax:209-722-4820
Practice Address - Street 1:2800 PARK AVE
Practice Address - Street 2:STE A
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3391
Practice Address - Country:US
Practice Address - Phone:209-722-4548
Practice Address - Fax:209-722-4820
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A792410Medicaid
CA00A792410Medicare ID - Type Unspecified
CA00A792410Medicaid