Healthcare Provider Details

I. General information

NPI: 1992343453
Provider Name (Legal Business Name): MARLENE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2019
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 IMPERIAL HWY
DOWNEY CA
90242-2813
US

IV. Provider business mailing address

12830 COLUMBIA WAY
DOWNEY CA
90242-4720
US

V. Phone/Fax

Practice location:
  • Phone: 562-922-6111
  • Fax:
Mailing address:
  • Phone: 323-434-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: