Healthcare Provider Details

I. General information

NPI: 1386864072
Provider Name (Legal Business Name): CHRISTOPHER WAYNE GARCIA D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16835 ALKALI DR STE M
LEMOORE CA
93245-9463
US

IV. Provider business mailing address

16835 ALKALI DR STE M
LEMOORE CA
93245-9463
US

V. Phone/Fax

Practice location:
  • Phone: 559-924-1541
  • Fax:
Mailing address:
  • Phone: 559-924-1541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A9125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: