Provider Demographics
NPI:1184455701
Name:GARCIA, MARIO ALEXANDER (DPT)
Entity type:Individual
Prefix:
First Name:MARIO
Middle Name:ALEXANDER
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 CARLOS ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-4313
Mailing Address - Country:US
Mailing Address - Phone:626-213-9647
Mailing Address - Fax:
Practice Address - Street 1:3413 W PACIFIC AVE STE 200
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1598
Practice Address - Country:US
Practice Address - Phone:818-841-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist