Provider Demographics
NPI:1396000485
Name:PADILLA GARCIA, EVA JOSEFINA (MD)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:JOSEFINA
Last Name:PADILLA 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 1:3815 E BELL RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2139
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:13555 W MCDOWELL RD STE 101
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2625
Practice Address - Country:US
Practice Address - Phone:623-935-4700
Practice Address - Fax:623-935-4707
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC38700207Q00000X
AZ64856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ125698Medicaid
AZZ289123OtherMEDICARE