Provider Demographics
NPI:1982656658
Name:GARCIA, DAVID (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 N UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4084
Mailing Address - Country:US
Mailing Address - Phone:719-548-1313
Mailing Address - Fax:719-592-0265
Practice Address - Street 1:7730 N UNION BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4084
Practice Address - Country:US
Practice Address - Phone:719-548-1313
Practice Address - Fax:719-592-0265
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO394213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01394006Medicaid
CO01394006Medicaid
COT60243Medicare UPIN