Provider Demographics
NPI:1346288222
Name:GARCIA, SALOMON G (MD)
Entity Type:Individual
Prefix:
First Name:SALOMON
Middle Name:G
Last Name:GARCIA
Suffix:
Gender:M
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 4797
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80155-4797
Mailing Address - Country:US
Mailing Address - Phone:303-220-9948
Mailing Address - Fax:
Practice Address - Street 1:2005 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5401
Practice Address - Country:US
Practice Address - Phone:303-220-9948
Practice Address - Fax:303-770-4389
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22248207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC476468Medicare UPIN
COC476468Medicare PIN
COC476468Medicare Oscar/Certification