Healthcare Provider Details

I. General information

NPI: 1518910744
Provider Name (Legal Business Name): CYNTHIA GARCIA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 W 72ND AVE
DENVER CO
80221-2721
US

IV. Provider business mailing address

1345 PLAZA CT N 1A
LAFAYETTE CO
80026-3531
US

V. Phone/Fax

Practice location:
  • Phone: 303-650-4460
  • Fax:
Mailing address:
  • Phone: 303-665-3036
  • Fax: 720-206-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA03078
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA17976
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085001561
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0003758
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: