Provider Demographics
NPI:1942235874
Name:GARCIA, RAYNADO (MD)
Entity Type:Individual
Prefix:
First Name:RAYNADO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 E VISALIA RD
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93223-1641
Mailing Address - Country:US
Mailing Address - Phone:559-594-4564
Mailing Address - Fax:559-594-5559
Practice Address - Street 1:682 E VISALIA RD
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:CA
Practice Address - Zip Code:93223-1641
Practice Address - Country:US
Practice Address - Phone:559-594-4564
Practice Address - Fax:559-594-5559
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36032207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A360320Medicaid
CA00A360320Medicaid
CA00A360320Medicare PIN