Provider Demographics
NPI:1255641080
Name:MICHAEL A GARCIA MD INC
Entity type:Organization
Organization Name:MICHAEL A GARCIA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-253-4420
Mailing Address - Street 1:25078 PEACHLAND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2533
Mailing Address - Country:US
Mailing Address - Phone:661-253-4420
Mailing Address - Fax:661-253-4425
Practice Address - Street 1:25078 PEACHLAND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2533
Practice Address - Country:US
Practice Address - Phone:661-253-4420
Practice Address - Fax:661-253-4425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76266207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADX962AOtherMEDICARE PTAN
CADX994XOtherMEDICARE INDIVIDUAL PTAN