Healthcare Provider Details

I. General information

NPI: 1306963756
Provider Name (Legal Business Name): FERNANDO D GARCIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 PARK BLVD
ORANGE COVE CA
93646-9322
US

IV. Provider business mailing address

1746 N MAPLE ST
VISALIA CA
93292-3138
US

V. Phone/Fax

Practice location:
  • Phone: 559-686-0882
  • Fax:
Mailing address:
  • Phone: 559-731-2837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA37360
License Number StateCA

VIII. Authorized Official

Name: FERNANDO D GARCIA
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 559-731-2837