Provider Demographics
NPI:1477291755
Name:GARCIA, MERIDIAN (CPSS)
Entity type:Individual
Prefix:MR
First Name:MERIDIAN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 S WOODROW ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5844
Mailing Address - Country:US
Mailing Address - Phone:385-318-2971
Mailing Address - Fax:
Practice Address - Street 1:5323 S WOODROW ST STE 200
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5844
Practice Address - Country:US
Practice Address - Phone:385-318-2971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ175T00000X
UT1338175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist