Provider Demographics
NPI:1417181470
Name:TERESA H GARCIA, M.D., INC
Entity Type:Organization
Organization Name:TERESA H GARCIA, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-547-8700
Mailing Address - Street 1:1140 W LA VETA AVE
Mailing Address - Street 2:SUITE 480
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4223
Mailing Address - Country:US
Mailing Address - Phone:714-547-8700
Mailing Address - Fax:714-547-2460
Practice Address - Street 1:1140 W LA VETA AVE
Practice Address - Street 2:SUITE 480
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4223
Practice Address - Country:US
Practice Address - Phone:714-547-8700
Practice Address - Fax:714-547-2460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71922261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG71922OtherCA STATE LICENSE
CA00G719220Medicaid
CA1841219243OtherNPI - INDIVIDUAL
CA00G719220Medicaid
CAWG719220BMedicare PIN