Provider Demographics
NPI:1346817715
Name:GARCIA, NICHOLAS SANTIAGO (DPT)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:SANTIAGO
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6527 W 86TH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3708
Mailing Address - Country:US
Mailing Address - Phone:714-313-1093
Mailing Address - Fax:
Practice Address - Street 1:2730 WILSHIRE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4724
Practice Address - Country:US
Practice Address - Phone:310-984-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist