Healthcare Provider Details

I. General information

NPI: 1205005402
Provider Name (Legal Business Name): OMAR GARCIA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32246 CLINTON KEITH RD STE 102
WILDOMAR CA
92595-7320
US

IV. Provider business mailing address

32246 CLINTON KEITH RD STE 102
WILDOMAR CA
92595-7320
US

V. Phone/Fax

Practice location:
  • Phone: 951-678-9063
  • Fax:
Mailing address:
  • Phone: 951-678-9063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number30360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: