MEDICARE: BOBBY ALLEN 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	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	A143665	CA
2	207V00000X	Obstetrics & Gynecology Physician	A143665	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RS2015-0879	OTHER	NM	UNIVERSITY OF NEW MEXICO TRAINING LICENSE

General Provider Information

NPI Number	:	1548520133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBBY ALLEN GARCIA M.D.

Provider Business Mailing Address
First Line	:	19330 JESSE LN STE 100
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5077
Country	:	US
Telephone Number	:	844-827-8000
Fax Number	:	951-263-7237

Provider Business Practice Location Address
First Line	:	19330 JESSE LN STE 100
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5077
Country	:	US
Telephone Number	:	844-827-8000
Fax Number	:	951-263-7237

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

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	10/13/2020

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