Healthcare Provider Details

I. General information

NPI: 1285721837
Provider Name (Legal Business Name): DONNA MARIE GARNIER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 E CARSON ST STE 102
CARSON CA
90745-2766
US

IV. Provider business mailing address

357 E CARSON ST STE 102
CARSON CA
90745-2766
US

V. Phone/Fax

Practice location:
  • Phone: 310-518-2737
  • Fax: 310-518-2060
Mailing address:
  • Phone: 310-518-2737
  • Fax: 310-518-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA12709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: