MEDICARE: PRINCESSA INTEGRATIVE MEDICAL ASSOCIATES

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	111NX0100X	Occupational Health Chiropractor	DC27810	CA
2	208000000X	Pediatrics Physician	G32408	CA
3	207R00000X	Internal Medicine Physician	A84167	CA

General Provider Information

NPI Number	:	1689870008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCESSA INTEGRATIVE MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	18520 VIA PRINCESSA
Second Line	:	SUITE C-2
City	:	CANYON COUNTRY
State	:	CA
Zip	:	91387-8326
Country	:	US
Telephone Number	:	661-424-0900
Fax Number	:	661-424-0924

Provider Business Practice Location Address
First Line	:	18520 VIA PRINCESSA
Second Line	:	SUITE C-2
City	:	CANYON COUNTRY
State	:	CA
Zip	:	91387-8326
Country	:	US
Telephone Number	:	661-424-0900
Fax Number	:	661-424-0924

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ROCHELLE C FELDMAN
Credential	:	M.D.
Telephone Number	:	661-424-0900

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	09/11/2025

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1003085911 — FIRMO C. GARCIA, M.D.
Practice Location Address:

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