Provider Demographics
NPI:1356759492
Name:GARCIA, JOHN (IDMT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86TH AEROMEDICAL EVACUATION SQ
Mailing Address - Street 2:OPC 2 BOX 16
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26012 CAROLINES AVE.
Practice Address - Street 2:
Practice Address - City:ANDERSEN AFB
Practice Address - State:GU
Practice Address - Zip Code:96542
Practice Address - Country:US
Practice Address - Phone:671-366-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians