MEDICARE: DR. RICHARD GARCIA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	G75626	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194935205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD GARCIA M.D.

Provider Business Mailing Address
First Line	:	4113 PEBBLE BEACH DR
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95219-1912
Country	:	US
Telephone Number	:	209-277-8262
Fax Number	:

Provider Business Practice Location Address
First Line	:	1339 S MADISON ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95206-1751
Country	:	US
Telephone Number	:	209-466-0863
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	10/24/2007

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