Provider Demographics
NPI:1932748324
Name:GARCIA, ALEC RYAN (RT(MR))
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:RYAN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:RT(MR)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24331 EL TORO RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-2752
Mailing Address - Country:US
Mailing Address - Phone:949-586-3200
Mailing Address - Fax:
Practice Address - Street 1:24331 EL TORO RD
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-2752
Practice Address - Country:US
Practice Address - Phone:949-586-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA574946207RM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)