Healthcare Provider Details
I. General information
NPI: 1760066096
Provider Name (Legal Business Name): M&G GARCIA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2021
Last Update Date: 05/12/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4240 TEQUESQUITE AVE
RIVERSIDE CA
92501-4016
US
IV. Provider business mailing address
7231 BOULDER AVE # 610
HIGHLAND CA
92346-3313
US
V. Phone/Fax
- Phone: 951-684-8000
- Fax:
- Phone: 951-505-9908
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
GARCIA
Title or Position: CEO
Credential:
Phone: 951-505-9908