Healthcare Provider Details

I. General information

NPI: 1053420745
Provider Name (Legal Business Name): ALFREDO MIGUEL GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 E ALMOND AVE STE 105
MADERA CA
93637-5752
US

IV. Provider business mailing address

9848 N SEDONA CIR
FRESNO CA
93720-5405
US

V. Phone/Fax

Practice location:
  • Phone: 559-673-6085
  • Fax: 559-673-6087
Mailing address:
  • Phone: 559-673-6085
  • Fax: 559-673-6087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA069814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: