Provider Demographics
NPI:1477331726
Name:GARCIA, ROLANDO A JR
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:A
Last Name:GARCIA
Suffix:JR
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 1:112 W 5TH ST APT 670
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2634
Mailing Address - Country:US
Mailing Address - Phone:323-861-8119
Mailing Address - Fax:
Practice Address - Street 1:112 W 5TH ST APT 670
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2634
Practice Address - Country:US
Practice Address - Phone:323-861-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program