Healthcare Provider Details

I. General information

NPI: 1790213080
Provider Name (Legal Business Name): ANDREW JESSE GARCIA MD, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 SAN PABLO ST STE 3450
LOS ANGELES CA
90033-5325
US

IV. Provider business mailing address

3630 S SEPULVEDA BLVD APT 117
LOS ANGELES CA
90034-6839
US

V. Phone/Fax

Practice location:
  • Phone: 323-865-1084
  • Fax:
Mailing address:
  • Phone: 520-302-0898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA190119
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: