Provider Demographics
NPI:1023269982
Name:GARCIA CAMPOS, ALYCIA (MD)
Entity type:Individual
Prefix:
First Name:ALYCIA
Middle Name:
Last Name:GARCIA CAMPOS
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 1:9880 BRIMHALL RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2701
Mailing Address - Country:US
Mailing Address - Phone:661-587-8990
Mailing Address - Fax:661-587-8980
Practice Address - Street 1:9880 BRIMHALL RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2701
Practice Address - Country:US
Practice Address - Phone:661-587-8990
Practice Address - Fax:661-587-8980
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
CAA107691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No282N00000XHospitalsGeneral Acute Care Hospital