Healthcare Provider Details

I. General information

NPI: 1629240478
Provider Name (Legal Business Name): ERNEST G GARCIA MS, AUDIOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8918 N DREY LN
PHOENIX AZ
85021-4577
US

IV. Provider business mailing address

8918 N DREY LN
PHOENIX AZ
85021-4577
US

V. Phone/Fax

Practice location:
  • Phone: 602-568-9173
  • Fax: 602-861-1921
Mailing address:
  • Phone: 602-861-1921
  • Fax: 602-861-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberDA142
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: