Provider Demographics
NPI:1336243724
Name:GARCIA, GAYDA YODY (MD)
Entity Type:Individual
Prefix:
First Name:GAYDA
Middle Name:YODY
Last Name:GARCIA
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 1:123 E F ST
Mailing Address - Street 2:UNIT F
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-5817
Mailing Address - Country:US
Mailing Address - Phone:310-830-6500
Mailing Address - Fax:310-830-6505
Practice Address - Street 1:123 E F ST
Practice Address - Street 2:UNIT F
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5817
Practice Address - Country:US
Practice Address - Phone:310-830-6500
Practice Address - Fax:310-830-6505
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53218208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A532180Medicaid
CAG28683Medicare UPIN
CA00A532180Medicaid