Healthcare Provider Details

I. General information

NPI: 1265587539
Provider Name (Legal Business Name): ANDRE SEBASTIAN GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7516 DEBUTANTE LN
SACRAMENTO CA
95828-4540
US

IV. Provider business mailing address

7516 DEBUTANTE LN
SACRAMENTO CA
95828-4540
US

V. Phone/Fax

Practice location:
  • Phone: 916-682-3311
  • Fax: 916-681-2431
Mailing address:
  • Phone: 916-682-3311
  • Fax: 916-681-2431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: