Healthcare Provider Details

I. General information

NPI: 1336243724
Provider Name (Legal Business Name): GAYDA YODY GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 04/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E F ST UNIT F
WILMINGTON CA
90744-5817
US

IV. Provider business mailing address

123 E F ST UNIT F
WILMINGTON CA
90744-5817
US

V. Phone/Fax

Practice location:
  • Phone: 310-830-6500
  • Fax: 310-830-6505
Mailing address:
  • Phone: 310-830-6500
  • Fax: 310-830-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA53218
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: