Healthcare Provider Details

I. General information

NPI: 1235049271
Provider Name (Legal Business Name): SKYLAR GARCES
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NOLAN AVE
CHULA VISTA CA
91911-3723
US

IV. Provider business mailing address

1201 NOLAN AVE
CHULA VISTA CA
91911-3723
US

V. Phone/Fax

Practice location:
  • Phone: 619-613-6144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberE0291536
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: