Provider Demographics
NPI:1366646093
Name:GARCIA, LEWIS
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 S TOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-6227
Mailing Address - Country:US
Mailing Address - Phone:909-628-6024
Mailing Address - Fax:909-591-0397
Practice Address - Street 1:2335 S TOWNE AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-6227
Practice Address - Country:US
Practice Address - Phone:909-628-6024
Practice Address - Fax:909-591-0397
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health