Provider Demographics
NPI:1891866331
Name:GARCIA, VICTORIA (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name: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 1:201 CEDAR ST SE STE 304
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4932
Mailing Address - Country:US
Mailing Address - Phone:505-843-7813
Mailing Address - Fax:505-843-6947
Practice Address - Street 1:201 CEDAR ST SE STE 304
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4932
Practice Address - Country:US
Practice Address - Phone:505-843-7813
Practice Address - Fax:505-843-6947
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2004-0567207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM99574721Medicaid
I24472Medicare UPIN
343509405Medicare PIN