Healthcare Provider Details

I. General information

NPI: 1982353033
Provider Name (Legal Business Name): JOSE ANTONIO GARCIA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 4TH AVE
GUSTINE CA
95322-1143
US

IV. Provider business mailing address

549 CROW HILL DR
NEWMAN CA
95360-9537
US

V. Phone/Fax

Practice location:
  • Phone: 209-854-1120
  • Fax:
Mailing address:
  • Phone: 209-585-6418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A21808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: