Provider Demographics
NPI:1811392871
Name:DAVID, JON PATRICK GARCIA (NP-C)
Entity Type:Individual
Prefix:
First Name:JON PATRICK
Middle Name:GARCIA
Last Name:DAVID
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16911 SAN FERNANDO MISSION BLVD # 398
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4250
Mailing Address - Country:US
Mailing Address - Phone:626-818-6343
Mailing Address - Fax:
Practice Address - Street 1:9233 W PICO BLVD STE 230
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1385
Practice Address - Country:US
Practice Address - Phone:310-356-8146
Practice Address - Fax:310-356-8142
Is Sole Proprietor?:No
Enumeration Date:2014-11-01
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95001244363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner