MEDICARE: MR. WILLIAM RUBEN GARCIA

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	183700000X	Pharmacy Technician	79534	CA

General Provider Information

NPI Number	:	1376728014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM RUBEN GARCIA

Provider Business Mailing Address
First Line	:	1140 E 2ND ST
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-1536
Country	:	US
Telephone Number	:	619-477-1102
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 E 2ND ST
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-1536
Country	:	US
Telephone Number	:	619-477-1102
Fax Number	:

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

Provider Enumeration Date	:	12/31/2007
Last Update Date	:	12/31/2007

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