Provider Demographics
NPI:1760423891
Name:GARCIA, PAMELA (DO)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 E. WALNUT AVE.
Mailing Address - Street 2:SUITE 250
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245
Mailing Address - Country:US
Mailing Address - Phone:310-301-2030
Mailing Address - Fax:310-306-5247
Practice Address - Street 1:1025 S ANAHEIM BLVD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5806
Practice Address - Country:US
Practice Address - Phone:714-533-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8132207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX81370Medicaid
CA00AX81320Medicaid
CAW20A8132AMedicare PIN
CAG79300Medicare UPIN
CA00AX81370Medicaid