Healthcare Provider Details

I. General information

NPI: 1942235874
Provider Name (Legal Business Name): RAYNADO GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

682 E VISALIA RD
FARMERSVILLE CA
93223-1641
US

IV. Provider business mailing address

682 E VISALIA RD
FARMERSVILLE CA
93223-1641
US

V. Phone/Fax

Practice location:
  • Phone: 559-594-4564
  • Fax: 559-594-5559
Mailing address:
  • Phone: 559-594-4564
  • Fax: 559-594-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA36032
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: