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NPI Code Detail

MEDICARE: BRIAN KEITH GARCIA

MEDICARE:   BRIAN KEITH 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
1174400000XSpecialist
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1912041138
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN KEITH GARCIA
Provider Business Mailing Address
First Line : 545 ESTUDILLO AVE
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-4611
Country : US
Telephone Number : 510-352-9200
Fax Number :
Provider Business Practice Location Address
First Line : 545 ESTUDILLO AVE
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-4611
Country : US
Telephone Number : 510-352-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2007
Last Update Date : 02/03/2011

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Directions to “ BRIAN KEITH GARCIA ” Practice Location

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