Healthcare Provider Details

I. General information

NPI: 1386861953
Provider Name (Legal Business Name): MARIA LINA G GARCIA-REYES REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3249 SAN FRANCISCO AVE
LONG BEACH CA
90806-1215
US

IV. Provider business mailing address

3249 SAN FRANCISCO AVE
LONG BEACH CA
90806-1215
US

V. Phone/Fax

Practice location:
  • Phone: 562-492-6892
  • Fax:
Mailing address:
  • Phone: 562-492-6892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number487912
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: