Healthcare Provider Details

I. General information

NPI: 1851745814
Provider Name (Legal Business Name): MR. CHRISTOPHER EMMANUEL GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 W CENTURY BLVD STE 303
LOS ANGELES CA
90045-6409
US

IV. Provider business mailing address

3923 W 110TH ST
INGLEWOOD CA
90303-2127
US

V. Phone/Fax

Practice location:
  • Phone: 323-290-2540
  • Fax:
Mailing address:
  • Phone: 323-804-2160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: