Healthcare Provider Details

I. General information

NPI: 1982170866
Provider Name (Legal Business Name): CESAR RUBEN GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 09/14/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5628 E SLAUSON AVE
COMMERCE CA
90040-2922
US

IV. Provider business mailing address

5628 E SLAUSON AVE
COMMERCE CA
90040-2922
US

V. Phone/Fax

Practice location:
  • Phone: 323-718-9966
  • Fax: 323-780-3211
Mailing address:
  • Phone: 323-718-9966
  • Fax: 323-780-3211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: