Healthcare Provider Details

I. General information

NPI: 1659895613
Provider Name (Legal Business Name): ALLAN GARCIA PALOMA RDCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 CREST AVE
ALAMO CA
94507-2641
US

IV. Provider business mailing address

6048 MOORES AVE
NEWARK CA
94560-4730
US

V. Phone/Fax

Practice location:
  • Phone: 650-743-8256
  • Fax:
Mailing address:
  • Phone: 650-474-9604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: