Provider Demographics
NPI:1275968455
Name:GARCIA, MICHAEL LUIS (MS, PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LUIS
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 BRIDGEWATER WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-0306
Mailing Address - Country:US
Mailing Address - Phone:503-750-1430
Mailing Address - Fax:
Practice Address - Street 1:2436 BRIDGEWATER WAY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-0306
Practice Address - Country:US
Practice Address - Phone:503-750-1430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0014763183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist